Immunogenicity and Reactogenicity of SARS-CoV-2 Vaccines in Patients With Cancer: The CANVAX Cohort Study.

Autor:	Naranbhai V; Massachusetts General Hospital Cancer Center, Division of Hematology/Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA.; Dana-Farber Cancer Institute, Boston, MA.; Center for the AIDS Programme of Research in South Africa, Durban, South Africa., Pernat CA; Massachusetts General Hospital Cancer Center, Division of Hematology/Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA., Gavralidis A; Massachusetts General Hospital Cancer Center, Division of Hematology/Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA.; Salem Hospital, Salem, MA., St Denis KJ; Ragon Institute of MGH, MIT and Harvard, Cambridge, MA., Lam EC; Ragon Institute of MGH, MIT and Harvard, Cambridge, MA., Spring LM; Massachusetts General Hospital Cancer Center, Division of Hematology/Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA., Isakoff SJ; Massachusetts General Hospital Cancer Center, Division of Hematology/Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA., Farmer JR; Division of Rheumatology, Allergy and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, MA., Zubiri L; Massachusetts General Hospital Cancer Center, Division of Hematology/Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA., Hobbs GS; Massachusetts General Hospital Cancer Center, Division of Hematology/Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA., How J; Massachusetts General Hospital Cancer Center, Division of Hematology/Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA.; Division of Hematology, Brigham and Women's Hospital, Boston, MA., Brunner AM; Massachusetts General Hospital Cancer Center, Division of Hematology/Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA., Fathi AT; Massachusetts General Hospital Cancer Center, Division of Hematology/Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA., Peterson JL; Massachusetts General Hospital Cancer Center, Division of Hematology/Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA., Sakhi M; Massachusetts General Hospital Cancer Center, Division of Hematology/Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA., Hambelton G; Massachusetts General Hospital Cancer Center, Division of Hematology/Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA., Denault EN; Massachusetts General Hospital Cancer Center, Division of Hematology/Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA., Mortensen LJ; Massachusetts General Hospital Cancer Center, Division of Hematology/Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA., Perriello LA; Massachusetts General Hospital Cancer Center, Division of Hematology/Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA., Bruno MN; Massachusetts General Hospital Cancer Center, Division of Hematology/Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA., Bertaux BY; Massachusetts General Hospital Cancer Center, Division of Hematology/Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA., Lawless AR; Massachusetts General Hospital Cancer Center, Division of Hematology/Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA., Jackson MA; Massachusetts General Hospital Cancer Center, Division of Hematology/Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA., Niehoff E; Massachusetts General Hospital Cancer Center, Division of Hematology/Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA., Barabell C; Massachusetts General Hospital Cancer Center, Division of Hematology/Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA., Nambu CN; Massachusetts General Hospital Cancer Center, Division of Hematology/Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA., Nakajima E; Massachusetts General Hospital Cancer Center, Division of Hematology/Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA., Reinicke T; Massachusetts General Hospital Cancer Center, Division of Hematology/Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA., Bowes C; Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA., Berrios-Mairena CJ; Department of Pathology, Massachusetts General Hospital, Boston, MA., Ofoman O; Department of Pathology, Massachusetts General Hospital, Boston, MA., Kirkpatrick GE; Department of Pathology, Massachusetts General Hospital, Boston, MA., Thierauf JC; Department of Pathology, Massachusetts General Hospital, Boston, MA., Reynolds K; Massachusetts General Hospital Cancer Center, Division of Hematology/Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA., Willers H; Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA., Beltran WG; Ragon Institute of MGH, MIT and Harvard, Cambridge, MA.; Department of Pathology, Massachusetts General Hospital, Boston, MA., Dighe AS; Department of Pathology, Massachusetts General Hospital, Boston, MA., Saff R; Division of Rheumatology, Allergy and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, MA., Blumenthal K; Division of Rheumatology, Allergy and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, MA., Sullivan RJ; Massachusetts General Hospital Cancer Center, Division of Hematology/Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA., Chen YB; Massachusetts General Hospital Cancer Center, Division of Hematology/Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA., Kim A; Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, MA., Bardia A; Massachusetts General Hospital Cancer Center, Division of Hematology/Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA., Balazs AB; Ragon Institute of MGH, MIT and Harvard, Cambridge, MA., Iafrate AJ; Massachusetts General Hospital Cancer Center, Division of Hematology/Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA.; Department of Pathology, Massachusetts General Hospital, Boston, MA., Gainor JF; Massachusetts General Hospital Cancer Center, Division of Hematology/Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA.
Jazyk:	angličtina
Zdroj:	Journal of clinical oncology : official journal of the American Society of Clinical Oncology [J Clin Oncol] 2022 Jan 01; Vol. 40 (1), pp. 12-23. Date of Electronic Publication: 2021 Nov 09.
DOI:	10.1200/JCO.21.01891
Abstrakt:	Purpose: The immunogenicity and reactogenicity of SARS-CoV-2 vaccines in patients with cancer are poorly understood. Methods: We performed a prospective cohort study of adults with solid-organ or hematologic cancers to evaluate anti-SARS-CoV-2 immunoglobulin A/M/G spike antibodies, neutralization, and reactogenicity ≥ 7 days following two doses of mRNA-1273, BNT162b2, or one dose of Ad26.COV2.S. We analyzed responses by multivariate regression and included data from 1,638 healthy controls, previously reported, for comparison. Results: Between April and July 2021, we enrolled 1,001 patients; 762 were eligible for analysis (656 had neutralization measured). mRNA-1273 was the most immunogenic (log 10 geometric mean concentration [GMC] 2.9, log 10 geometric mean neutralization titer [GMT] 2.3), followed by BNT162b2 (GMC 2.4; GMT 1.9) and Ad26.COV2.S (GMC 1.5; GMT 1.4; P < .001). The proportion of low neutralization (< 20% of convalescent titers) among Ad26.COV2.S recipients was 69.9%. Prior COVID-19 infection (in 7.1% of the cohort) was associated with higher responses ( P < .001). Antibody titers and neutralization were quantitatively lower in patients with cancer than in comparable healthy controls, regardless of vaccine type ( P < .001). Receipt of chemotherapy in the prior year or current steroids were associated with lower antibody levels and immune checkpoint blockade with higher neutralization. Systemic reactogenicity varied by vaccine and correlated with immune responses ( P = .002 for concentration, P = .016 for neutralization). In 32 patients who received an additional vaccine dose, side effects were similar to prior doses, and 30 of 32 demonstrated increased antibody titers (GMC 1.05 before additional dose, 3.17 after dose). Conclusion: Immune responses to SARS-CoV-2 vaccines are modestly impaired in patients with cancer. These data suggest utility of antibody testing to identify patients for whom additional vaccine doses may be effective and appropriate, although larger prospective studies are needed. Competing Interests: Laura M. SpringConsulting or Advisory Role: Novartis, AvrobioResearch Funding: Tesaro (Inst), Merck (Inst)Travel, Accommodations, Expenses: Merck, Tesaro Steven J. IsakoffConsulting or Advisory Role: AbbVie, OncoPep, Puma Biotechnology, Seattle Genetics, Novartis, Paxman Coolers LtdResearch Funding: Genentech (Inst), PharmaMar (Inst), AbbVie (Inst), OncoPep (Inst), Merck (Inst), AstraZeneca/MedImmune (Inst), Outcomes4Me (Inst) Jocelyn R. FarmerConsulting or Advisory Role: Bristol Myers Squibb FoundationResearch Funding: Bristol Myers Squibb Foundation Leyre ZubiriConsulting or Advisory Role: Merck Gabriela S. HobbsConsulting or Advisory Role: Incyte, AbbVie, Novatis, Blueprint Medicines, Keros TherapeuticsResearch Funding: Incyte, Constellation Pharmaceuticals Andrew M. BrunnerConsulting or Advisory Role: Celgene, Novartis, Takeda, Agios, Bristol Myers Squibb/Celgene, Acceleron PharmaResearch Funding: Celgene, Takeda, Novartis, GlaxoSmithKline, AstraZeneca Amir T. FathiConsulting or Advisory Role: Agios, Novartis, Takeda, Astellas Pharma, Daiichi Sankyo, Bristol Myers Squibb, Forty Seven, AbbVie, Kite, a Gilead Company, Trovagene, Pfizer, Seattle Genetics, Amgen, Trillium Therapeutics, Blueprint Medicines, Kura Oncology, Foghorn Therapeutics, Genentech, Ipsen, MorphoSys, ServierResearch Funding: Takeda (Inst), Agios (Inst), Bristol Myers Squibb (Inst), AbbVie (Inst), Servier (Inst) Brittany Y. BertauxEmployment: Partners (I) Elizabeth NiehoffStock and Other Ownership Interests: Biogen Inc, Blueprint Medicines, Crispr Therapeutics, InVitae, LabCorp, Natera Inc, Pacific Biosciences Christian N. NambuEmployment: Massachusetts General Hospital Cancer Center, AFC Urgent Care (I)Stock and Other Ownership Interests: Moderna Therapeutics Onosereme OfomanEmployment: Massachusetts General Hospital Kerry ReynoldsEmployment: TeladocStock and Other Ownership Interests: Biogen (I)Other Relationship: Project DataSphere Henning WillersResearch Funding: Apple Inc Wilfredo-Garcia BeltranPatents, Royalties, Other Intellectual Property: European Patent—New therapy for treating graft-versus-host disease (EP3575320A1) Kimberly BlumenthalLeadership: Novocardia (I)Stock and Other Ownership Interests: Devoted Health (I), Novocardia (I)Honoraria: UpToDate, GA²LEN ANACAREResearch Funding: National Institute of Health (NIH)—K01AI125631, Massachusetts General Hospital, Transformative Scholar Award Ryan J. SullivanConsulting or Advisory Role: Novartis, Merck, Replimune, Asana Biosciences, Alkermes, Eisai, Pfizer, Iovance Biotherapeutics, OncoSec, AstraZeneca, Bristol Myers SquibbResearch Funding: Amgen (Inst), Lilly (Inst), BioMed Valley Discoveries (Inst), Merck (Inst), Deciphera (Inst), Roche/Genentech (Inst), Moderna Therapeutics (Inst), Sanofi (Inst), Aeglea Biotherapeutics (Inst), Asana Biosciences (Inst), Viralytics (Inst), Compugen (Inst), Neon Therapeutics (Inst), Pfizer (Inst), BeiGene (Inst), Rubius Therapeutics (Inst), Strategia (Inst) Yi-Bin ChenConsulting or Advisory Role: Magenta Therapeutics, Incyte, Kiadis Pharma, AbbVie, Equillium, Daiichi Sankyo/Lilly, Celularity, Actinium Pharmaceuticals Arthur KimConsulting or Advisory Role: Kintor PharmaceuticalPatents, Royalties, Other Intellectual Property: Uptodate, Chapter Royalties Aditya BardiaConsulting or Advisory Role: Novartis (Inst), Genentech, Pfizer (Inst), Spectrum Pharmaceuticals, bioTheranostics, Merck, Radius Health (Inst), Immunomedics (Inst), Genentech/Roche (Inst), Innocrin Pharma (Inst), Sanofi, Puma Biotechnology, Daiichi Sankyo/Astra Zeneca, Foundation Medicine, PhilipsResearch Funding: Genentech (Inst), Novartis (Inst), Pfizer (Inst), Merck (Inst), Sanofi (Inst), Radius Health (Inst), Immunomedics (Inst), AstraZeneca/Daiichi Sankyo (Inst)Open Payments Link: https://openpaymentsdata.cms.gov/physician/523675 A. John IafrateStock and Other Ownership Interests: Archer BiosciencesConsulting or Advisory Role: Repare Therapeutics, Kinnate Biopharma, Oncoclinicas Brasil, PAIGE.AIPatents, Royalties, Other Intellectual Property: ArcherDx exclusive license to AMP technology Justin F. GainorThis author is a member of the JCO Editorial Board. Journal policy recused the author from having any role in the peer review of this manuscript.Employment: Ironwood Pharmaceuticals (I)Stock and Other Ownership Interests: Ironwood Pharmaceuticals (I)Honoraria: Merck, Incyte, ARIAD, Novartis, Pfizer, TakedaConsulting or Advisory Role: Genentech, Bristol Myers Squibb, Theravance, Loxo, Takeda, Array BioPharma, Amgen, Merck, Agios, Regeneron, Oncorus, Jounce Therapeutics, Blueprint Medicines, Gilead Sciences, Lilly, Moderna TherapeuticsResearch Funding: Genentech, ARIAD, Merck, Novartis, Bristol Myers Squibb, Adaptimmune, AstraZeneca, Jounce Therapeutics, Blueprint Medicines, Moderna Therapeutics, Tesaro, Alexo Therapeutics, Array BioPharmaNo other potential conflicts of interest were reported.
Databáze:	MEDLINE
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