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COVID Booster Shot Increases Protection For Cancer Patients

The COVID-19 booster injections generated immune responses in cancer patients who did not have detectable antibodies after the primary vaccination course, the researchers said.

Among seronegative patients, a third dose of the vaccine achieved a seroconversion rate of 56%, reported Balazs Halmos, MD, MS, of the Montefiore Einstein Cancer Center in New York City, and colleagues.

These findings call for “broad efforts to provide a third vaccination for these patients,” they wrote in Cancer cell.

In the study, 99 patients underwent repeated testing for anti-SARS-CoV-2 (anti-S) antibodies after completing their primary vaccine series. While the majority of patients (94% with hematologic malignancies and 100% with solid tumors) maintained detectable anti-S IgG titers> 50 AU / mL at 4 to 6 months, median titer levels fell. significantly during this period – compared to baseline levels of 5,162 AU / mL to 724.6 AU / mL at follow-up (P

The anti-COVID immunity before and after a booster vaccination was then evaluated in 88 patients (median age 69 years) with a diagnosis of cancer (31 with solid tumors and 57 with hematologic malignancies); 73% were on active treatment at the time of their recall.

Of these patients, 70% received the Pfizer-BioNTech vaccine, 25% received the Moderna vaccine, and 5% received the Johnson & Johnson / Janssen vaccine as primary injections. With the exception of eight patients, all received a booster injection with the type of vaccine initially received. The median time since the last vaccination was 177 days.

Sixty-four percent were HIV positive before the booster, while the remaining 36% were HIV negative. All but one HIV negative patient had hematologic malignancies.

Halmos and colleagues found that patients with hematologic malignancies had both a statistically significantly lower pre-boost antibody response, as well as a smaller change in mean anti-S IgG titers after boosting by compared to those with solid tumors (10,034 versus 22,686 AU / mL; P= 0.00263).

Four weeks after the booster vaccination, 70 of 88 patients (80%) had higher antibody levels than before receiving their booster.

Of the 14 patients who remained seronegative after the booster, all had B-cell malignancies. Eight of these patients were on active treatment at the time of their booster vaccination.

Even patients who received treatment within 30 days of the booster vaccination had a statistically significant risk of seroconversion (P= 0.02).

Previous treatment with a Bruton tyrosine kinase inhibitor or anti-CD20 therapy, or both, was significantly associated with a decrease in antibody seroconversion before and after the booster (P= 0.01333) and the title (P= 0.0000575).

While this study showed that additional dosing can boost immunity in cancer patients, it also showed that some will not benefit from a third dose of mRNA, “highlighting the need for continued efforts to to develop valid laboratory correlates of COVID-19 immunity and studies evaluating the potential benefit of subsequent homologous vaccine doses, heterologous vaccinations, passive immunizations and other unique approaches for these patients, ”Halmos wrote and his colleagues.

  • Mike Bassett is a writer specializing in oncology and hematology. He is based in Massachusetts.

Disclosures

Halmos did not report any disclosures. Other co-authors have reported multiple relationships with the industry.