COVID-19 vaccination effective for patients with renal cell carcinoma
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Most patients with renal cell carcinoma who received commercially available COVID-19 vaccines mounted sufficient antibody response, according to study results presented at International Kidney Cancer Symposium.
Researchers reported a seroconversion rate of 92.1% at 2 months after the first vaccine dose.
“Recently published studies exploring the immune response following COVID-19 vaccination [among patients with cancer] have shown that patients with solid tumor malignancies have higher rates of seroconversion than those with hematologic malignancies,” researcher Jasnoor Malhotra, BS, clinical research assistant at City of Hope, told Healio. “Our data supports the current published literature showing increased immunogenicity following vaccination [among patients with solid tumors]. However, there is still more work to be done, as there remains a paucity of data investigating clinical factors that correlate with poor immune response [or] lack of seroconversion.”
Several studies have examined the biological impact of COVID-19 vaccination among individuals with solid tumors. Seroconversion rates in those studies ranged from 86% to 98%. However, those studies included a limited number of patients with renal cell carcinoma and more information is needed about vaccine efficacy and responses in this population, according to study background.
Malhotra and colleagues identified 38 patients (median age, 63 years; range, 57-70; 68.4% men; 81.6% white) with renal cell carcinoma who had not received any COVID-19 vaccine.
More than half (57.9%) had received immunotherapy, 34.2% had received targeted therapy and 2.6% had undergone chemotherapy. Comorbidity types included cardiovascular (63.1%), autoimmune (21.1%) and pulmonary (7.9%), and 7.9% had diabetes.
Study protocol stipulated blood collection prior to vaccination, as well as at three time points — 2, 6 and 12 months — after administration of the first vaccine dose. Study participants receiving systemic treatment also provided blood samples during three consecutive therapy cycles.
Two-thirds (65.8%) received the BNT162b2 vaccine (Pfizer) and one-third (34.2%) received the mRNA-1273 vaccine (Moderna).
Investigators used an enzyme-linked immunosorbent assay to assess blood specimens for antibody titers. They reported results as immune status ratios.
Thirty-five study participants (92.1%) achieved seroconversion at 2 months after their first vaccine dose.
“Some of the results were unexpected,” Malhotra told Healio. “Within the kidney cancer cohort, a majority of patients were receiving immune-based treatments. As the mechanism of action of immune-based treatments involves stimulating the immune system to target the cancer, we thought that these patients would demonstrate a stronger immune response after receiving the vaccination than patients who received other treatments — primarily targeted drugs. However, there turned out to be no significant difference in the rate of seroconversion across different treatments administered, which was definitely surprising.
“For the overall cohort, we did expect that patients would seroconvert following vaccination, so it was encouraging to see that reflected in the results for the most part,” Malhotra added. “[Although] there were some patients who didn't achieve sufficient antibody titers, we were able to find possible clinical correlations for this. For example, one patient was receiving immunosuppressive drugs at the time of vaccination.”
Specimen collection will continue so investigators can assess for changes in immune status ratio values at 6 and 12 months, as well as after receipt of booster doses.
“We have further amended our original study to include blood collection at 2 months following administration of the booster doses of various COVID-19 vaccines in order to get a better understanding of the trend in antibody titers at that time point,” Malhotra said. “We are planning to run T-cell receptor sequencing on samples from different time points to identify vaccine-induced clonotypes [among patients with renal cell carcinoma].”
Researchers acknowledged limitations to their study, including a small sample size and “lack of synchrony” in specimen collection time points across the cohort.
However, the findings encourage continued COVID-19 vaccination among individuals with renal cell carcinoma, researchers concluded.
“Every patient is different, and this is reflected in their biological response to the COVID-19 vaccine,” Malhotra told Healio. “Our results are encouraging in that a majority of patients are able to develop a sufficient immune response. Moving forward, further vaccination efforts are vital to maintain immunity against COVID-19, which can be fatal [for patients with renal cell carcinoma] who may be immunocompromised. Patients should definitely have a discussion with their oncologists — if they haven't already — about getting the booster dose to enhance their COVID-19 immunity.”
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Malhotra J, et al. Abstract E42. Presented at: International Kidney Cancer Symposium; Nov. 5-6, 2021; Austin, Texas.
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