Study of efficacy and longevity of immune response to third and fourth doses of COVID-19 vaccines in patients with cancer: A single arm clinical trial

Cancer patients show increased morbidity with COVID-19 and need effective immunization strategies. Many healthcare regulatory agencies recommend administering 'booster' doses of COVID-19 vaccines beyond the standard two-dose series, for this group of patients. Therefore, studying the effic...

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Published in:eLife 2023-03, Vol.12
Main Authors: Thakkar, Astha, Pradhan, Kith, Duva, Benjamin, Carreno, Juan Manuel, Sahu, Srabani, Thiruthuvanathan, Victor, Campbell, Sean, Gallego, Sonia, Bhagat, Tushar D, Rivera, Johanna, Choudhary, Gaurav, Olea, Raul, Sabalza, Maite, Shapiro, Lauren C, Lee, Matthew, Quinn, Ryann, Mantzaris, Ioannis, Chu, Edward, Will, Britta, Pirofski, Liise-Anne, Krammer, Florian, Verma, Amit, Halmos, Balazs
Format: Article
Language:English
Subjects:
Ad26COVS1
Antibodies, Viral
cancer
COVID-19
COVID-19 - prevention & control
COVID-19 Vaccines
Humans
Immunity
immunocompromised
Medicine
Neoplasms - therapy
Prospective Studies
RNA, Viral
SARS CoV-2
vaccine
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Summary:Cancer patients show increased morbidity with COVID-19 and need effective immunization strategies. Many healthcare regulatory agencies recommend administering 'booster' doses of COVID-19 vaccines beyond the standard two-dose series, for this group of patients. Therefore, studying the efficacy of these additional vaccine doses against SARS-CoV-2 and variants of concern is of utmost importance in this immunocompromised patient population. We conducted a prospective single arm clinical trial enrolling patients with cancer that had received two doses of mRNA or one dose of AD26.CoV2.S vaccine and administered a third dose of mRNA vaccine. We further enrolled patients that had no or low responses to three mRNA COVID vaccines and assessed the efficacy of a fourth dose of mRNA vaccine. Efficacy was assessed by changes in anti-spike antibody, T-cell activity, and neutralization activity, which were again assessed at baseline and 4 weeks. We demonstrate that a third dose of COVID-19 vaccine leads to seroconversion in 57% of patients that were seronegative after primary vaccination series. The immune response is durable as assessed by anti-SARS-CoV-2 (anti-S) antibody titers, T-cell activity, and neutralization activity against wild-type (WT) SARS-CoV2 and BA1.1.529 at 6 months of follow-up. A subset of severely immunocompromised hematologic malignancy patients that were unable to mount an adequate immune response (titer
ISSN:2050-084X
2050-084X
DOI:10.7554/eLife.83694