Humoral Response and Safety After a Fourth Dose of the SARS-CoV-2 BNT162b2 Vaccine in Cancer Patients Undergoing Active Treatment-Results of a Prospective Observational Study

Overview

Journal Vaccines (Basel)

Date 2024 Jan 22

PMID 38250889

Authors

Chiara Citterio

Claudia Biasini

Camilla Di Nunzio

Giuliana Lo Cascio

Luigi Cavanna

Affiliations

Soon will be listed here.

Abstract

Only a few studies have been carried out on the efficacy and safety of a fourth dose of the COVID-19 vaccine in patients with cancer. In this prospective observational study, we aimed to assess the serological response and safety of the fourth booster shot of the BNT162b2 vaccine in 79 cancer patients, vaccinated between 1 March and 25 August 2022, under systemic anticancer therapy. The primary endpoint was to assess the increase in the anti-SARS-CoV-2 antibodies; secondary endpoints were the vaccine safety and side effects. Consequently, 40 patients (50.63%) revealed the maximum detection values in their IgG titers before the fourth dose of the vaccine, while 39 patients (49.37%) did not. Primary endpoint: Of 39 patients, 36 (92.31%) showed a significant increase in the anti-SARS-CoV-2 IgG titers, and 32 of them (82.05%) reached the maximum titration values. Secondary endpoints: The most common adverse events were mild in severity and included injection site pain, erythema and tiredness. The majority of the adverse reactions reported were grade 1 and no grade 3 and 4 reactions were detected. Our data provide evidence that a fourth dose of the BNT162b2 anti-SARS-CoV-2 vaccine is effective and safe in patients with solid tumors in active anticancer treatment.

References

Wu Z, McGoogan J . Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020; 323(13):1239-1242. DOI: 10.1001/jama.2020.2648. View

Peleg Hasson S, Waissengrin B, Shachar E, Hodruj M, Fayngor R, Brezis M . Rapid Implementation of Telemedicine During the COVID-19 Pandemic: Perspectives and Preferences of Patients with Cancer. Oncologist. 2021; 26(4):e679-e685. PMC: 8013179. DOI: 10.1002/onco.13676. View

Cavanna L, Proietto M, Citterio C, Anselmi E, Zaffignani E, Stroppa E . COVID-19 Vaccination in Cancer Patients Older Than 70 Years Undergoing Active Treatment. Seroconversion Rate and Safety. Vaccines (Basel). 2022; 10(2). PMC: 8878129. DOI: 10.3390/vaccines10020164. View

Cohen I, Campisi-Pfinto S, Rozenberg O, Colodner R, Bar-Sela G . The Humoral Response of Patients With Cancer to Breakthrough COVID-19 Infection or the Fourth BNT162b2 Vaccine Dose. Oncologist. 2023; 28(4):e225-e227. PMC: 10078898. DOI: 10.1093/oncolo/oyad003. View

Luo J, Tong L, Crotty B, Somai M, Taylor B, Osinski K . Telemedicine Adoption during the COVID-19 Pandemic: Gaps and Inequalities. Appl Clin Inform. 2021; 12(4):836-844. PMC: 8426040. DOI: 10.1055/s-0041-1733848. View

Cavanna L, Citterio C, Biasini C, Madaro S, Bacchetta N, Lis A . COVID-19 vaccines in adult cancer patients with solid tumours undergoing active treatment: Seropositivity and safety. A prospective observational study in Italy. Eur J Cancer. 2021; 157:441-449. PMC: 8410513. DOI: 10.1016/j.ejca.2021.08.035. View

Desai A, Sachdeva S, Parekh T, Desai R . COVID-19 and Cancer: Lessons From a Pooled Meta-Analysis. JCO Glob Oncol. 2020; 6:557-559. PMC: 7193801. DOI: 10.1200/GO.20.00097. View

Samol J . Early COVID-19 booster is beneficial in cancer patients. Ann Acad Med Singap. 2023; 52(1):3-5. View

Martinelli S, Pascucci D, Laurenti P . Humoral response after a fourth dose of SARS-CoV-2 vaccine in immunocompromised patients. Results of a systematic review. Front Public Health. 2023; 11:1108546. PMC: 10076800. DOI: 10.3389/fpubh.2023.1108546. View

10.

Cavanna L, Citterio C, Di Nunzio C, Biasini C, Palladino M, Ambroggi M . Prevalence of COVID-19 Infection in Asymptomatic Cancer Patients in a District With High Prevalence of SARS-CoV-2 in Italy. Cureus. 2021; 13(3):e13774. PMC: 8027955. DOI: 10.7759/cureus.13774. View

11.

Mai A, Lee A, Tay R, Shapiro L, Thakkar A, Halmos B . Booster doses of COVID-19 vaccines for patients with haematological and solid cancer: a systematic review and individual patient data meta-analysis. Eur J Cancer. 2022; 172:65-75. PMC: 9163022. DOI: 10.1016/j.ejca.2022.05.029. View

12.

Lu R, Zhao X, Li J, Niu P, Yang B, Wu H . Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet. 2020; 395(10224):565-574. PMC: 7159086. DOI: 10.1016/S0140-6736(20)30251-8. View

13.

Cavanna L, Citterio C, Toscani I, Franco C, Magnacavallo A, Caprioli S . Cancer patients with COVID-19: a retrospective study of 51 patients in the district of Piacenza, Northern Italy. Future Sci OA. 2021; 7(1):FSO645. PMC: 7687531. DOI: 10.2144/fsoa-2020-0157. View

14.

Huret L, Stoekle H, Benmaziane A, Beuzeboc P, Herve C . Cancer and COVID-19: ethical issues concerning the use of telemedicine during the pandemic. BMC Health Serv Res. 2022; 22(1):703. PMC: 9132171. DOI: 10.1186/s12913-022-08097-w. View

15.

Pinato D, Patel M, Scotti L, Colomba E, Dolly S, Loizidou A . Time-Dependent COVID-19 Mortality in Patients With Cancer: An Updated Analysis of the OnCovid Registry. JAMA Oncol. 2021; 8(1):114-122. PMC: 8777559. DOI: 10.1001/jamaoncol.2021.6199. View

16.

Cavanna L, Citterio C, Cattadori E, Bosi C, Caprioli S . Re: The first report on coronavirus disease 2019 vaccine refusal by patients with cancer in Italy: Early data from a single-institute survey: Consideration of recent findings on COVID-19 vaccine adherence in cancer patients. Eur J Cancer. 2021; 158:251-252. PMC: 8463312. DOI: 10.1016/j.ejca.2021.07.048. View

17.

Lasagna A, Bergami F, Lilleri D, Percivalle E, Quaccini M, Comolli G . Humoral and cellular response before and after the fourth BNT162b2 vaccine dose in patients with solid tumors on active treatment. Ann Oncol. 2022; 33(11):1207-1208. PMC: 9341169. DOI: 10.1016/j.annonc.2022.07.012. View

18.

Ambroggi M, Citterio C, Vecchia S, Riva A, Mordenti P, Cavanna L . Impact of the COVID-19 pandemic on the oncologic activities (diagnosis, treatment, clinical trials enrollment) of a general hospital in a district with high prevalence of SARS-COV-2 in Italy. Support Care Cancer. 2022; 30(4):3225-3231. PMC: 8720559. DOI: 10.1007/s00520-021-06667-y. View

19.

Bonelli F, Sarasini A, Zierold C, Calleri M, Bonetti A, Vismara C . Clinical and Analytical Performance of an Automated Serological Test That Identifies S1/S2-Neutralizing IgG in COVID-19 Patients Semiquantitatively. J Clin Microbiol. 2020; 58(9). PMC: 7448652. DOI: 10.1128/JCM.01224-20. View

20.

Tan W, Tan J, Lim J, Tan R, Lee A, Leong F . COVID-19 Severity and Waning Immunity After up to 4 mRNA Vaccine Doses in 73 608 Patients With Cancer and 621 475 Matched Controls in Singapore: A Nationwide Cohort Study. JAMA Oncol. 2023; 9(9):1221-1229. PMC: 10346511. DOI: 10.1001/jamaoncol.2023.2271. View