Efficacy of mRNA anti-SARS-CoV-2 vaccination and dynamics of humoral immune response in patients with solid tumors: results from the institutional registry of an Italian tertiary cancer center

Giovanni Fucà; Mara Lecchi; Chiara Maura Ciniselli; Arianna Ottini; Andrea Spagnoletti; Laura Mazzeo; Daniele Morelli; Paola Frati; Martina Stroscia; Elisabella Ebrahem; Elisa Sottotetti; Giulia Galli; Maria Grazia D'Elia; Riccardo Lobefaro; Monika Ducceschi; Lorenza Di Guardo; Sherrie Bhoori; Salvatore Provenzano; Marco Platania; Monica Niger; Elena Colombo; Federico Nichetti; Matteo Duca; Licia Rivoltini; Roberta Mortarini; Paolo Baili; Giovanni Apolone; Filippo de Braud; Paolo Verderio; Silvia Damian

doi:10.1177/17588359221108687

Efficacy of mRNA anti-SARS-CoV-2 vaccination and dynamics of humoral immune response in patients with solid tumors: results from the institutional registry of an Italian tertiary cancer center

Ther Adv Med Oncol. 2022 Jul 27:14:17588359221108687. doi: 10.1177/17588359221108687. eCollection 2022.

Authors

Giovanni Fucà¹, Mara Lecchi², Chiara Maura Ciniselli², Arianna Ottini¹, Andrea Spagnoletti¹, Laura Mazzeo¹, Daniele Morelli², Paola Frati³, Martina Stroscia³, Elisabella Ebrahem¹, Elisa Sottotetti¹, Giulia Galli¹, Maria Grazia D'Elia¹, Riccardo Lobefaro¹, Monika Ducceschi⁴, Lorenza Di Guardo¹, Sherrie Bhoori⁵, Salvatore Provenzano⁶, Marco Platania¹, Monica Niger¹, Elena Colombo¹, Federico Nichetti¹, Matteo Duca¹, Licia Rivoltini³, Roberta Mortarini⁷, Paolo Baili², Giovanni Apolone⁸, Filippo de Braud⁹, Paolo Verderio, Silvia Damian¹⁰

Affiliations

¹ Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
² Unit of Bioinformatics and Biostatistics, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
³ Unit of Immunotherapy of Human Tumors, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
⁴ Department of Gynecologic Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
⁵ Hepato-Pancreatic-Biliary Surgery and Liver Transplantation, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
⁶ Medical Oncology Unit 2, Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
⁷ Human Tumors Immunobiology Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
⁸ Scientific Directorate, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
⁹ Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy Oncology and Hemato-Oncology Department, University of Milan, Milan, Italy.
¹⁰ Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Giacomo Venezian, 1, Milan 20133, Italy.

Abstract

Background: Systemic immunosuppression characterizing cancer patients represents a concern regarding the efficacy of anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination, and real-world evidence is needed to define the efficacy and the dynamics of humoral immune response to mRNA-based anti-SARS-CoV-2 vaccines.

Methods: We conducted an observational study that included patients with solid tumors who were candidates for mRNA anti-SARS-CoV-2 vaccination at the Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. The primary objective was to monitor the immunologic response to the mRNA anti-SARS-CoV-2 vaccination in terms of anti-spike antibody levels. All the patients received two doses of the mRNA-1273 vaccine or the BNT162b2 vaccine. Healthcare workers served as a control group of healthy subjects.

Results: Among the 243 patients included in the present analysis, 208 (85.60%) and 238 (97.94%) resulted seroconverted after the first and the second dose of vaccine, respectively. Only five patients (2.06%) had a negative titer after the second dose. No significant differences in the rate of seroconversion after two vaccine doses were observed in patients as compared with the control group of healthy subjects. Age and anticancer treatment class had an independent impact on the antibody titer after the second dose of vaccination. In a subgroup of 171 patients with available data about the third timepoint, patients receiving immunotherapy with immune checkpoint inhibitors seem to have a higher peak of antibodies soon after the second dose (3 weeks after), but a more pronounced decrease at a late timepoint (3 months after).

Conclusions: The systemic immunosuppression characterizing cancer patients did not seem to dramatically affect the humoral response to anti-SARS-CoV-2 mRNA vaccines in our population of patients with solid tumors. Further investigation is needed to dissect the interplay between immunotherapy and longitudinal dynamics of humoral response to mRNA vaccines, as well as to analyze the cellular response to mRNA vaccines in cancer patients.

Keywords: COVID19; SARS-CoV-2; cancer patients; mRNA vaccine; solid tumors; vaccination.