Anti-COVID-19 immunity dynamics were assessed in patients with cancer in a prospective clinical trial. Waning of immunity was detected 4-6 months post-vaccination with significant increases in anti-spike IgG titers after booster dosing, and 56% of seronegative patients seroconverted post-booster vaccination. Prior anti-CD20/BTK inhibitor therapy was associated with reduced vaccine efficacy.
Antibodies, Viral/biosynthesis , COVID-19 Vaccines/immunology , COVID-19/prevention & control , Immunization, Secondary , Immunoglobulin G/biosynthesis , Neoplasms/immunology , SARS-CoV-2/immunology , Agammaglobulinaemia Tyrosine Kinase/antagonists & inhibitors , Antibodies, Viral/blood , Antibodies, Viral/immunology , Antigens, Viral/immunology , COVID-19/complications , COVID-19/immunology , Follow-Up Studies , Humans , Immunocompromised Host , Immunogenicity, Vaccine , Immunoglobulin G/blood , Immunoglobulin G/immunology , Neoplasms/complications , Neoplasms/drug therapy , Prospective Studies , Protein Kinase Inhibitors/adverse effects , Protein Kinase Inhibitors/therapeutic use , Rituximab/adverse effects , Rituximab/therapeutic use , Seroconversion , Spike Glycoprotein, Coronavirus/immunology , Vaccination
Patients with cancer have been identified in several studies to be at high risk of developing severe COVID-19; however, rates of SARS-CoV-2 IgG seroconversion and its association with cancer types and anti-cancer therapy remain obscure. We conducted a retrospective cohort study in patients with cancer that underwent SARS-CoV-2 IgG testing. Two hundred and sixty-one patients with a cancer diagnosis underwent SARS-CoV-2 IgG testing and demonstrated a high rate of seroconversion (92%). However, significantly lower seroconversion was observed in patients with hematologic malignancies (82%), patients that received anti-CD-20 antibody therapy (59%) and stem cell transplant (60%). Interestingly, all 17 patients that received immunotherapy, including 16 that received anti-PD-1/PD-L1 monoclonal antibodies, developed SARS-Cov-2 IgG antibodies (100% seroconversion). These data show differential rates of seroconversion in specific patient groups and bear importance for clinical monitoring and vaccination strategies that are being developed to mitigate the COVID-19 pandemic.
Antibodies, Viral/blood , Immunoglobulin G/blood , Neoplasms/immunology , SARS-CoV-2/immunology , Seroconversion , Adult , Aged , Aged, 80 and over , COVID-19 Nucleic Acid Testing , Female , Humans , Male , Middle Aged , Neoplasms/drug therapy , Retrospective Studies , Young Adult