Antibody response to three-dose anti-SARS-CoV-2 mRNA-vaccination in treated solid cancer patients
Davide Dalu1, Maciej Tarkowski2, Lorenzo Ruggieri1
1Department of Medical Oncology, Luigi Sacco University Hospital, ASST Fatebenefratelli Sacco, Milan, Italy.
Abstract:
Solid cancer patients are at higher risk of SARS-CoV-2 infection and severe complications. Moreover, vaccine-induced antibody response is impaired in patients on anticancer treatment. In this retrospective, observational, hypothesis-generating, cohort study, we assessed the antibody response to the third dose of mRNA vaccine in a convenience sample of patients on anticancer treatment, comparing it to that of the primary two-dose cycle. Among 99 patients included, 62.6% were ≥60 years old, 32.3% males, 67.7% with advanced disease. Exactly 40.4% were receiving biological therapy, 16.2% chemotherapy only and 7.1% both treatments. After the third dose, seroconversion rate seems to increase significantly, especially in non-responders to two doses. Heterologous vaccine-type regimen (two-dose mRNA-1273 and subsequent tozinameran or vice versa) results in higher antibody levels. This explorative study suggests that repeated doses of mRNA-vaccines could be associated with a better antibody response in this population. Furthermore, heterologous vaccine-type three-dose vaccination seems more effective in this population. Since this is a hypothesis-generating study, adequately statistically powered studies should validate these results.
Insights
Solid cancer patients receiving anticancer treatment showed improved antibody response after a third mRNA vaccine dose. Heterologous vaccination regimens (mixing vaccine types) appeared more effective in boosting antibody levels in this vulnerable population.
Area of Science:
- Oncology
- Immunology
- Vaccinology
Background:
- Solid cancer patients face increased risk of SARS-CoV-2 infection and severe outcomes.
- Anticancer treatments can impair vaccine-induced antibody responses in cancer patients.
Purpose of the Study:
- To assess the antibody response to a third mRNA vaccine dose in patients undergoing anticancer treatment.
- To compare the response to the primary two-dose vaccination cycle.
- To explore the effectiveness of heterologous vaccine regimens.
Main Methods:
- Retrospective, observational, hypothesis-generating cohort study.
- Included 99 patients on various anticancer therapies (biological, chemotherapy).
- Assessed antibody response after the third mRNA vaccine dose.
Main Results:
- Significant increase in seroconversion rate after the third dose, particularly in initial non-responders.
- Heterologous vaccine-type regimens (e.g., mRNA-1273 followed by tozinameran, or vice versa) yielded higher antibody levels.
- Repeated mRNA vaccine doses may enhance antibody response in cancer patients.
Conclusions:
- Repeated mRNA vaccine doses show potential for improved antibody response in solid cancer patients.
- Three-dose heterologous vaccination appears more effective in this population.
- Further statistically powered studies are needed to validate these findings.
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