Six-month humoral and cellular immune response to the third dose of BNT162b2 anti-SARS-CoV-2 vaccine in patients with solid tumors: a longitudinal cohort study with a focus on the variants of concern.


Journal

ESMO open
ISSN: 2059-7029
Titre abrégé: ESMO Open
Pays: England
ID NLM: 101690685

Informations de publication

Date de publication:
10 2022
Historique:
received: 30 05 2022
revised: 18 07 2022
accepted: 02 08 2022
pubmed: 28 8 2022
medline: 25 10 2022
entrez: 27 8 2022
Statut: ppublish

Résumé

The role and the durability of the immunogenicity of the third dose of vaccine against COVID-19 variants of concern in cancer patients have to be elucidated. We have prospectively evaluated the immunogenicity of the third dose of the SARS-CoV-2 BNT162b2 messenger RNA vaccine in triggering both humoral and cell-mediated immune response in patients with solid tumors undergoing active treatment 6 months after the booster. Neutralizing antibody (NT Ab) titers and total anti-spike immunoglobulin G concentrations were measured in serum. Heparinized whole blood samples were used for the SARS-CoV-2 interferon-γ release assay (IGRA). Six months after the third dose only two patients (2.4%) showed negative spike-specific immunoglobulin G antibody levels (<33.8 BAU/ml). The median level of SARS-CoV-2 NT Abs decreased and only 39/83 (47%) subjects showed maximum levels of NT Abs. T-cellular positive response was observed in 38/61 (62.3%) patients; the highest median level of response was observed 21 days after the third dose (354 mIU/ml, interquartile range 83.3-846.3 mIU/ml). The lowest median level of NT Ab response was observed against the Omicron variant (1 : 10, interquartile range 1 : 10-1 : 40) with a significant reduced rate of responder subjects with respect to the wild-type strain (77.5% versus 95%; P = 0.0022) and Delta variant (77.5% versus 93.7%; P = 0.0053). During the follow-up period, seven patients (8%) had a confirmed post-vaccination infection, but none of them required hospitalization or oxygen therapy. Our work highlights a significant humoral and cellular immune response among patients with solid tumors 6 months after the third BNT162b2 vaccine dose, although a reduction in neutralizing activity against Omicron was observed.

Sections du résumé

BACKGROUND
The role and the durability of the immunogenicity of the third dose of vaccine against COVID-19 variants of concern in cancer patients have to be elucidated.
PATIENTS AND METHODS
We have prospectively evaluated the immunogenicity of the third dose of the SARS-CoV-2 BNT162b2 messenger RNA vaccine in triggering both humoral and cell-mediated immune response in patients with solid tumors undergoing active treatment 6 months after the booster. Neutralizing antibody (NT Ab) titers and total anti-spike immunoglobulin G concentrations were measured in serum. Heparinized whole blood samples were used for the SARS-CoV-2 interferon-γ release assay (IGRA).
RESULTS
Six months after the third dose only two patients (2.4%) showed negative spike-specific immunoglobulin G antibody levels (<33.8 BAU/ml). The median level of SARS-CoV-2 NT Abs decreased and only 39/83 (47%) subjects showed maximum levels of NT Abs. T-cellular positive response was observed in 38/61 (62.3%) patients; the highest median level of response was observed 21 days after the third dose (354 mIU/ml, interquartile range 83.3-846.3 mIU/ml). The lowest median level of NT Ab response was observed against the Omicron variant (1 : 10, interquartile range 1 : 10-1 : 40) with a significant reduced rate of responder subjects with respect to the wild-type strain (77.5% versus 95%; P = 0.0022) and Delta variant (77.5% versus 93.7%; P = 0.0053). During the follow-up period, seven patients (8%) had a confirmed post-vaccination infection, but none of them required hospitalization or oxygen therapy.
CONCLUSIONS
Our work highlights a significant humoral and cellular immune response among patients with solid tumors 6 months after the third BNT162b2 vaccine dose, although a reduction in neutralizing activity against Omicron was observed.

Identifiants

pubmed: 36029652
pii: S2059-7029(22)00204-6
doi: 10.1016/j.esmoop.2022.100574
pmc: PMC9353611
pii:
doi:

Substances chimiques

COVID-19 Vaccines 0
BNT162 Vaccine 0
Antibodies, Viral 0
Viral Vaccines 0
Antibodies, Neutralizing 0
Immunoglobulin G 0
Oxygen S88TT14065

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

100574

Informations de copyright

Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Déclaration de conflit d'intérêts

Disclosure The authors have declared no conflicts of interest. Authorship All authors contributed to the article and approved the submitted version.

Auteurs

A Lasagna (A)

Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. Electronic address: a.lasagna@smatteo.pv.it.

F Bergami (F)

Molecular Virology Unit, Department of Microbiology and Virology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.

D Lilleri (D)

Molecular Virology Unit, Department of Microbiology and Virology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.

E Percivalle (E)

Molecular Virology Unit, Department of Microbiology and Virology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.

M Quaccini (M)

Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.

F Serra (F)

Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.

G Comolli (G)

Molecular Virology Unit, Department of Microbiology and Virology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.

A Sarasini (A)

Molecular Virology Unit, Department of Microbiology and Virology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.

J C Sammartino (JC)

Molecular Virology Unit, Department of Microbiology and Virology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.

A Ferrari (A)

Molecular Virology Unit, Department of Microbiology and Virology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.

F Arena (F)

Molecular Virology Unit, Department of Microbiology and Virology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.

S Secondino (S)

Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.

D Cicognini (D)

Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.

R Schiavo (R)

Microbiology Unit, Hospital Guglielmo da Saliceto, Piacenza, Italy.

G Lo Cascio (G)

Microbiology Unit, Hospital Guglielmo da Saliceto, Piacenza, Italy.

L Cavanna (L)

Oncology Unit, Hospital Guglielmo da Saliceto, Piacenza, Italy.

F Baldanti (F)

Molecular Virology Unit, Department of Microbiology and Virology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Departments of Clinical, Surgical, Diagnostic and Pediatric Sciences, Pavia, Italy.

P Pedrazzoli (P)

Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy.

I Cassaniti (I)

Molecular Virology Unit, Department of Microbiology and Virology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.

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Classifications MeSH