Efficacy and impact of SARS-CoV-2 vaccination on cancer treatment for patients with breast cancer: A multicenter, prospective, observational study
Journal of Clinical Oncology
; 40(16), 2022.
Article
in English
| EMBASE | ID: covidwho-2009515
ABSTRACT
Background:
Vaccination is an essential strategy to prevent infection in the SARS-CoV-2 pandemic. However, there are concerns about vaccine efficacy and the impact of vaccination on cancer treatment. Additionally, the emergence of novel variants may affect vaccination efficacy. This multi-center, prospective, observational study investigated the efficacy and impact of vaccination against SARS-CoV-2 variants on treatment among breast cancer patients in Japan.Methods:
Breast cancer patients scheduled to be vaccinated with the SARS-CoV-2 vaccine from May to November 2021 were included. They were stratified into five groups according to their cancer treatment no treatment, endocrine therapy, CDK4/6 inhibitor, chemotherapy, anti-HER2 therapy. Serum samples were collected before the first vaccination and after the second vaccination. Immunoglobulin (Ig)G levels against the SARS-CoV-2 S protein and neutralizing antibody titers against wild-type (WT), alpha (α), delta (δ), kappa (κ), and omicron (o) variants were measured by ELISA assay. The effect of vaccination on cancer treatment was also investigated.Results:
There were 85 eligible patients (no treatment, n = 5;endocrine therapy, n = 30;CDK4/6 inhibitor, n = 14;chemotherapy, n = 21;and anti-HER2 therapy, n = 15) with a median age of 65 years. The overall seroconversion rate of anti-SARS-CoV-2 IgG was 95.3%. The seroconversion rate of the chemotherapy group was 81.8%. The anti-SARS-CoV-2 IgG antibody concentration was positively correlated with the lymphocyte count before vaccination (r = 0.232, p = 0.039). Overall neutralizing antibody titers against each variant were significantly lower than for WT. Overall positive rates of neutralizing antibodies against WT, α, δ, γ, and o variants were 90.2%, 81.7%, 96.3%, 84.1%, and 8.5%, respectively. A downward trend of neutralizing antibody titers against each variant was seen in chemotherapy and CDK4/6 inhibitor groups compared with other groups. Significant decreases were detected in neutralizing antibody titers against WT, α, and κ variants in the chemotherapy group, and WT and α variants in the CDK4/6 inhibitor group compared with the no treatment group. Withdrawal or postponement of systemic therapy because of vaccination was only observed in one patient.Conclusions:
Our data support SARS-CoV-2 vaccination for cancer patients being treated with systemic therapy. However, neutralizing antibody titers against the o variant were very low even after two vaccinations among patients with or without cancer treatment. Further, a decrease in neutralizing antibody titer was suggested during chemotherapy and CDK4/6 inhibitor, raising concerns about the impact on long-term infection prevention. For these patients, infection-preventive behaviors should be recommended even after vaccination. They will also be good candidates for booster vaccinations.
cyclin dependent kinase 4; cyclin dependent kinase 6; endogenous compound; epidermal growth factor receptor 2; immunoglobulin G; neutralizing antibody; SARS-CoV-2 antibody; SARS-CoV-2 vaccine; aged; breast cancer; cancer patient; cancer therapy; chemotherapy; conference abstract; controlled study; drug therapy; drug withdrawal; enzyme linked immunosorbent assay; female; gene expression; hormonal therapy; human; human tissue; immunoglobulin blood level; infection prevention; Japan; lymphocyte count; major clinical study; multicenter study; nonhuman; observational study; positivity rate; prevention; prospective study; revaccination; seroconversion; Severe acute respiratory syndrome coronavirus 2; systemic therapy; vaccination; wild type
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Type of study:
Experimental Studies
/
Observational study
/
Prognostic study
Topics:
Vaccines
Language:
English
Journal:
Journal of Clinical Oncology
Year:
2022
Document Type:
Article
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