Immunogenicity and safety of COVID-19 vaccine in lung cancer patients receiving anticancer treatment: A prospective multicenter cohort study

ABSTRACT

IntroductionThis study assessed the immunogenicity and safety of BNT162b2 mRNA vaccine in lung cancer patients receiving anticancer treatment using two immunoassays. Methods: We enrolled lung cancer patients receiving anticancer treatment and non-cancer patients with chronic diseases; all participants were fully vaccinated with the BNT162b2 vaccine. Blood samples were collected before the first and second vaccinations and 4 {+/-} 1 weeks after the second vaccination. Anti-acute respiratory syndrome coronavirus-2 (SARS-CoV-2) spike protein S1 subunit receptor-binding domain antibody titers were measured using the Architect SARS-CoV-2 IgG II Quant (Abbott Laboratory) and Elecsys Anti-SARS-CoV-2 S (Roche Diagnostics). ResultsFifty-five lung cancer patients and 38 non-cancer patients were included in the immunogenicity analysis. Lung cancer patients showed significant increase in the geometric mean antibody titer, which was significantly lower than that in the non-cancer patients after the first (30 vs. 121 AU/mL, p<0.001 on Architect; 4.0 vs 1.2 U/mL, p<0.001, on Elecsys) and second vaccinations (1632 vs. 3472 AU/mL, p=0.005, on Architect; 213 vs 573 A/mL, p=0.002, on Elecsys). The adjusted odds ratio (OR) for seroprotection was significantly lower in the lung cancer patients. Analysis of the anticancer treatment types showed that the adjusted OR for seroprotection was significantly lower in lung cancer patients receiving cytotoxic agents. Lung cancer patients showed no increase in the number of adverse reactions. ConclusionsBNT162b2 vaccination in lung cancer patients undergoing anticancer treatment significantly increased antibody titers and showed acceptable safety. However, the immunogenicity in these patients could be inadequate compared with that in non-cancer patients.