PMID- 34597941
OWN - NLM
STAT- MEDLINE
DCOM- 20211028
LR  - 20211204
IS  - 2059-7029 (Electronic)
IS  - 2059-7029 (Linking)
VI  - 6
IP  - 5
DP  - 2021 Oct
TI  - Reduced humoral immune response after BNT162b2 coronavirus disease 2019 messenger 
      RNA vaccination in cancer patients under antineoplastic treatment.
PG  - 100274
LID - S2059-7029(21)00236-2 [pii]
LID - 10.1016/j.esmoop.2021.100274 [doi]
LID - 100274
AB  - BACKGROUND: Cancer patients are at a higher risk of developing severe coronavirus 
      disease 2019 (COVID-19). However, the safety and efficacy of COVID-19 vaccination 
      in cancer patients undergoing treatment remain unclear. PATIENTS AND METHODS: In 
      this interventional prospective multicohort study, priming and booster doses of 
      the BNT162b2 COVID-19 vaccine were administered 21 days apart to solid tumor 
      patients receiving chemotherapy, immunotherapy, targeted or hormonal therapy, and 
      patients with a hematologic malignancy receiving rituximab or after allogeneic 
      hematopoietic stem cell transplantation. Vaccine safety and efficacy (until 3 
      months post-booster) were assessed. Anti-severe acute respiratory syndrome 
      coronavirus 2 (SARS-CoV-2) receptor-binding domain (RBD) antibody levels were 
      followed over time (until 28 days after the booster) and in vitro SARS-CoV-2 50% 
      neutralization titers (NT50) toward the wild-type Wuhan strain were analyzed 28 
      days after the booster. RESULTS: Local and systemic adverse events (AEs) were 
      mostly mild to moderate (only 1%-3% of patients experienced severe AEs). Local, 
      but not systemic, AEs occurred more frequently after the booster dose. 
      Twenty-eight days after the booster vaccination of 197 cancer patients, 
      RBD-binding antibody titers and NT50 were lower in the chemotherapy group 234.05 
      IU/ml [95% confidence interval (CI) 122.10-448.66] and 24.54 (95% CI 
      14.50-41.52), respectively compared with healthy individuals [1844.93 IU/ml (95% 
      CI 1383.57-2460.14) and 122.63 (95% CI 76.85-195.67), respectively], irrespective 
      of timing of vaccination during chemotherapy cycles. Extremely low antibody 
      responses were seen in hematology patients receiving rituximab; only two patients 
      had RBD-binding antibody titers necessary for 50% protection against symptomatic 
      SARS-CoV-2 infection (<200 IU/ml) and only one had NT50 above the limit of 
      detection. During the study period, five cancer patients tested positive for 
      SARS-CoV-2 infection, including a case of severe COVID-19 in a patient receiving 
      rituximab, resulting in a 2-week hospital admission. CONCLUSION: The BNT162b2 
      vaccine is well-tolerated in cancer patients under active treatment. However, the 
      antibody response of immunized cancer patients was delayed and diminished, mainly 
      in patients receiving chemotherapy or rituximab, resulting in breakthrough 
      infections.
CI  - Copyright (c) 2021. Published by Elsevier Ltd.
FAU - Peeters, M
AU  - Peeters M
AD  - Multidisciplinary Oncologic Centre Antwerp (MOCA), Antwerp University Hospital, 
      Edegem, Belgium; Center for Oncological Research (CORE), Integrated Personalized 
      and Precision Oncology Network (IPPON), University of Antwerp and Antwerp 
      University Hospital, Edegem, Belgium. Electronic address: marc.peeters@uza.be.
FAU - Verbruggen, L
AU  - Verbruggen L
AD  - Multidisciplinary Oncologic Centre Antwerp (MOCA), Antwerp University Hospital, 
      Edegem, Belgium.
FAU - Teuwen, L
AU  - Teuwen L
AD  - Multidisciplinary Oncologic Centre Antwerp (MOCA), Antwerp University Hospital, 
      Edegem, Belgium.
FAU - Vanhoutte, G
AU  - Vanhoutte G
AD  - Multidisciplinary Oncologic Centre Antwerp (MOCA), Antwerp University Hospital, 
      Edegem, Belgium.
FAU - Vande Kerckhove, S
AU  - Vande Kerckhove S
AD  - SD Infectious Diseases in Humans, Service Immune response, Sciensano, Brussels, 
      Belgium.
FAU - Peeters, B
AU  - Peeters B
AD  - Department of Laboratory Medicine, Antwerp University Hospital, Edegem, Belgium.
FAU - Raats, S
AU  - Raats S
AD  - Multidisciplinary Oncologic Centre Antwerp (MOCA), Antwerp University Hospital, 
      Edegem, Belgium.
FAU - Van der Massen, I
AU  - Van der Massen I
AD  - Multidisciplinary Oncologic Centre Antwerp (MOCA), Antwerp University Hospital, 
      Edegem, Belgium.
FAU - De Keersmaecker, S
AU  - De Keersmaecker S
AD  - Multidisciplinary Oncologic Centre Antwerp (MOCA), Antwerp University Hospital, 
      Edegem, Belgium.
FAU - Debie, Y
AU  - Debie Y
AD  - Multidisciplinary Oncologic Centre Antwerp (MOCA), Antwerp University Hospital, 
      Edegem, Belgium.
FAU - Huizing, M
AU  - Huizing M
AD  - Biobank Antwerp, Edegem, Belgium.
FAU - Pannus, P
AU  - Pannus P
AD  - SD Epidemiology and Public Health, Sciensano, Brussels, Belgium.
FAU - Neven, K
AU  - Neven K
AD  - SD Epidemiology and Public Health, Sciensano, Brussels, Belgium.
FAU - Arien, K K
AU  - Arien KK
AD  - Virology Unit, Institute of Tropical Medicine Antwerp, Antwerp, Belgium; 
      Department of Biomedical Sciences, University of Antwerp, Edegem, Belgium.
FAU - Martens, G A
AU  - Martens GA
AD  - Department of Laboratory Medicine, AZ Delta General Hospital, Roeselare, Belgium.
FAU - Van Den Bulcke, M
AU  - Van Den Bulcke M
AD  - SD Epidemiology and Public Health, Sciensano, Brussels, Belgium.
FAU - Roelant, E
AU  - Roelant E
AD  - Clinical Trial Center (CTC), CRC Antwerp, Antwerp University Hospital, University 
      of Antwerp, Edegem, Belgium; StatUa, Center for Statistics, University of 
      Antwerp, Antwerp, Belgium.
FAU - Desombere, I
AU  - Desombere I
AD  - SD Infectious Diseases in Humans, Service Immune response, Sciensano, Brussels, 
      Belgium.
FAU - Anguille, S
AU  - Anguille S
AD  - Multidisciplinary Oncologic Centre Antwerp (MOCA), Antwerp University Hospital, 
      Edegem, Belgium.
FAU - Goossens, M
AU  - Goossens M
AD  - SD Epidemiology and Public Health, Sciensano, Brussels, Belgium.
FAU - Vandamme, T
AU  - Vandamme T
AD  - Multidisciplinary Oncologic Centre Antwerp (MOCA), Antwerp University Hospital, 
      Edegem, Belgium; Center for Oncological Research (CORE), Integrated Personalized 
      and Precision Oncology Network (IPPON), University of Antwerp and Antwerp 
      University Hospital, Edegem, Belgium.
FAU - van Dam, P
AU  - van Dam P
AD  - Multidisciplinary Oncologic Centre Antwerp (MOCA), Antwerp University Hospital, 
      Edegem, Belgium; Center for Oncological Research (CORE), Integrated Personalized 
      and Precision Oncology Network (IPPON), University of Antwerp and Antwerp 
      University Hospital, Edegem, Belgium.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20210908
PL  - England
TA  - ESMO Open
JT  - ESMO open
JID - 101690685
RN  - 0 (Antineoplastic Agents)
RN  - 0 (COVID-19 Vaccines)
RN  - 0 (RNA, Messenger)
RN  - N38TVC63NU (BNT162 Vaccine)
SB  - IM
MH  - *Antineoplastic Agents
MH  - BNT162 Vaccine
MH  - *COVID-19
MH  - COVID-19 Vaccines
MH  - Humans
MH  - Immunity, Humoral
MH  - *Neoplasms
MH  - Prospective Studies
MH  - RNA, Messenger
MH  - SARS-CoV-2
MH  - Vaccination
PMC - PMC8423808
OTO - NOTNLM
OT  - BNT162b2 COVID-19 vaccination
OT  - anti-RBD IgG antibody response
OT  - antineoplastic treatment
OT  - cancer
OT  - safety
COIS- Disclosure MP declares to have an advisory role within Remedus. All other authors 
      have declared no conflicts of interest.
EDAT- 2021/10/02 06:00
MHDA- 2021/10/29 06:00
PMCR- 2021/09/08
CRDT- 2021/10/01 20:25
PHST- 2021/07/16 00:00 [received]
PHST- 2021/08/16 00:00 [revised]
PHST- 2021/09/01 00:00 [accepted]
PHST- 2021/10/02 06:00 [pubmed]
PHST- 2021/10/29 06:00 [medline]
PHST- 2021/10/01 20:25 [entrez]
PHST- 2021/09/08 00:00 [pmc-release]
AID - S2059-7029(21)00236-2 [pii]
AID - 100274 [pii]
AID - 10.1016/j.esmoop.2021.100274 [doi]
PST - ppublish
SO  - ESMO Open. 2021 Oct;6(5):100274. doi: 10.1016/j.esmoop.2021.100274. Epub 2021 Sep 
      8.