Second COVID-19 vaccine dose equally effective in people with, without solid cancers
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Patients with solid tumor cancers sustained similar COVID-19 antibody levels as individuals without cancer 6 months after the second dose of the mRNA COVID-19 vaccine, according to study results published in Cancer Discovery.
“Since the beginning of the pandemic, we have prospectively followed clinical outcomes of COVID-19, as well as vaccinations among [patients with cancer] with solid tumors on active cancer therapy to study their potential unique response,” Irit Ben-Aharon, MD, PhD, professor in the division of oncology at Rambam Health Care Campus in Israel, told Healio. “Our former study evaluating immunogenicity and safety of the two doses of the BNT162b2 mRNA COVID-19 vaccine [Pfizer, BioNTech] among patients with solid tumors who are on active IV treatment indicated that after the first vaccine dose, there was a lag in the seroconversion rate among [patients with cancer] on active treatment.”
Mounting data suggest a substantial difference between patients with solid tumors and patients with hematologic malignancies, Ben-Aharon added.
“We should strive to carry out evidence-based decisions. It is therefore essential to prospectively study clinical outcomes of COVID-19 disease, as well as the impact of the vaccine on this heterogeneous population, so that we can tailor the right recommendations,” she said.
Investigators previously reported the short-term efficacy, immunogenicity and safety of the BNT162b2 mRNA COVID-19 vaccine among patients with solid tumors undergoing cancer treatment at Rambam Health Care Campus oncology center.
For the current study, they assessed and compared outcomes at 6 months after the second vaccine dose among 154 patients (median age, 66 years; 55% men) with cancer vs. 135 age-matched, otherwise healthy health care workers who served as controls (median age, 63 years; 56% women).
Common cancer types included gastrointestinal (36%), lung (23%), breast (17%) and genitourinary (11%). Most patients (84%) had metastatic disease. Chemotherapy was the most common treatment type (62%), followed by biological agents (36%) and immunotherapy (30%). Of note, some patients received more than one treatment type.
Results showed 79% of patients with cancer vs. 84% of controls were seropositive at 6 months after the second vaccine dose.
Among patients, seronegative serological status was more likely among those who received chemotherapy compared with other treatment modalities (27% vs. 10%; P = .02).
Researchers additionally observed similar decreases in serology titer among both groups. One patient with cancer was diagnosed with COVID-19, and no controls were diagnosed.
“In view of recent reports on decreased efficacy over time among formerly vaccinated individuals, it seems reasonable to recommend booster vaccination to patients with cancer, as recommended to the general population — especially among those aged older than 60 years,” Ben-Aharon said. “In our study, we observed that for all outcomes, patients with cancer depicted a similar trend as the general population. Recent studies indicate a different profile for patients with hematologic cancers and those who have undergone transplant. Therefore, the [National Comprehensive Cancer Network] guidelines, which prioritize immunocompromised patients first, followed by patients with solid tumors on active treatment, are practical. We continue to follow this population with the booster over time and further study potential mechanisms that may underlie the response to the vaccine among patients with solid tumors.”
For more information:
Irit Ben-Aharon, MD, PhD, can be reached at i_benaharon@rambam.health.gov.il.
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