Infectious Disease

The booster dose of the COVID-19 vaccine will benefit patients with cancer

January 04, 2022

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Shapiro does not report any relevant financial information. The relevant financial information from all authors can be found in the study.

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Cancer patients who had no measurable immune response after a full COVID-19 vaccination had “excellent potentiation” after receiving a third booster dose, according to the results of a study in Cancer Cell.

“Our research supports COVID-19 booster vaccination for the majority of cancer patients as we show broad increases in antibody titers in both solid tumors and hematologic malignancies.” Lauren C. Shapiro, MD, Hematology and Oncology Fellow at Montefiore Medical Center and Albert Einstein College of Medicine, Healio said. “It also highlights the significant evidence of decreased immunity 4 to 6 months after standard vaccination, which can be saved to an even higher level than post-standard vaccination. Overall, we believe our results underscore the continued benefits of COVID-19 vaccines, including booster vaccines that are given to all of our patients. “

Antibody response to COVID-19 boosters.

Data from Shapiro LC, et al. Cancer cell. 2021; doi: 10.1016 / j.ccell.2021.11.006

The current study builds on ongoing research at the Montefiore Einstein Cancer Center, including a June finding that most cancer patients have developed robust antiviral immunity after receiving a standard COVID-19 vaccination, as determined by anti-spike IgG antibodies is measured. However, in that study, about 20% of blood cancer patients had lower seroconversion rates, identifying a population in need of new immunization strategies, Shapiro said.

Lauren C. Shapiro, MD

Lauren C. Shapiro

“We were hoping to evaluate whether a booster vaccination could offer these patients new protection,” Shapiro told Healio. “Given our previous studies, we were also in a unique position to have evidence of declining immunity months after standard vaccination (especially given that breakthrough infections are reported around the world) and how effective a booster vaccination can be in addressing those dwindling ones To restore the immune response with the aim of “providing cancer patients with longer and more permanent protection against COVID-19.”

Shapiro and colleagues analyzed two cohorts of cancer patients: a follow-up immunity cohort of 99 patients (mean age 68 years; range 30-91; 60% women) who were fully vaccinated against COVID-19 and post-vaccinated for the presence of antiviral antibodies and a cohort of 88 patients (mean age 69 years; range 30-91; 52% women) who also received a booster dose of the COVID-19 vaccine.

The results indicated that most of those in the follow-up cohort who had detectable antibodies saw a decrease in those antibodies when retested 4 to 6 months later.

Four weeks after receiving the booster dose, 79.5% of patients in the booster cohort had higher antibody levels than before vaccination. In addition, 56% of those who had no detectable antibodies after the standard vaccination had them after receiving the booster.

“However, we find that patients who have had previous anti-CD20 therapy – especially within the last 6 months – or Bruton tyrosine kinase inhibitor therapy are at an increased risk of not responding to a booster dose,” said Shapiro.

Shapiro said the seroconversion rate of 56% pleasantly surprised the research team.

“The fact that the majority of these patients showed evidence of increased T-cell activity despite the lack of an antibody response also surprised us, which suggests that other types of immune protection could also play a role in the potential protection against COVID-19 infection,” said Shapiro. “Our evidence of diminishing immunity over time did not surprise us; However, it was great to see how well a booster vaccination can dramatically increase immunity with just one additional dose. “

Shapiro called for more research that could help the smaller segment of cancer patients, especially those with hematological malignancies who had previously received B-cell depletion therapies and who lack a measurable antibody response after standard vaccination.

“We would like future research to focus on novel immunization strategies to protect these patients, including potential (heterologous) vaccination, prophylactic antibody therapeutics and further research into alternative immune protection methods such as T-cell activity,” said Shapiro Healio. “Our group has initiated a randomized controlled study to investigate the use of a homologous vs. a heterologous COVID vaccination especially in patients with cancer who still lack a measurable antibody response after the booster vaccination. The delimitation will begin shortly. “

For more informations:

Lauren C. Shapiro, MD, reachable at Department on Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461; Email: lshapiro@montefiore.org.

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