In a new study published by Gounant et al in the Journal of Thoracic Oncology, researchers from France showed that SARS–CoV-2 vaccines are safe and effective in patients with thoracic cancer, most of whom are immunized after two doses. A third shot given to 11% of patients with persistent low antibody titers resulted in an 88% immunization rate.
Although the COVID-19 vaccines have been proven safe and effective in the general population, little is known about whether patients with lung cancer would develop a protective anti-spike antibody response because these patients were excluded from most COVID-19 vaccine trials. Previous studies demonstrated that patients with lung cancer suffered a 30% mortality rate from COVID-19, which is significantly higher than the general population.
Study Details
The researchers enrolled 306 patients with lung cancer, with a median age of 67.0 years. Of these, 283 patients received two vaccine doses at 28-day intervals. SARS–CoV-2–spike antibodies were measured using the Abbot ARCHITECT SARS–CoV-2 IgG immunoassay, prior to the first injection of an mRNA vaccine, as well as after the fourth week, and at 2 to 16 weeks after the second vaccine dose.
After a 6- to 7-month median follow-up, only eight patients (2.6%) contracted proven symptomatic SARS–CoV-2 infection, with rapid favorable evolution. Of 269 serologic results available beyond day 14 post second vaccine dose, 17 (6.3%) were still negative (< 50 arbitrary units/mL), while 34 (11%) were < 300 arbitrary units/mL (12.5th percentile)—the threshold from which a perfect correlation was found between anti-S antibodies and neutralizing antibodies—using a pseudo-neutralization assay.
In multivariate analysis, only age, chemotherapy as last systemic treatment within 3 months, and chronic corticosteroid treatment were significantly associated with a lack of immunization. Thirty patients received a third vaccine dose, with only three patients showing persistent negative serology thereafter, whereas the others demonstrated clear seroconversion.
No anaphylaxis reaction occurred among the 306 patients, with 587 vaccine doses administered. Safety data were available for 278 patients (90.1%), without significant safety concerns.
“Although, this report involves, to the best our knowledge, the largest series of patients [with thoracic cancer] receiving anti–SARS–CoV-2 mRNA vaccines that has been published to date, the sample size of the different patient subsets remains limited,” the authors wrote.
The study was conducted by Valérie Gounant, MD, MSc, and Gérard Zalcman, MD, PhD, of the University Hospital Bichat-Claude Bernard in Paris.
Disclosure: For full disclosures of the study authors, visit www.jto.org.
