Humoral response after SARS-CoV-2 mRNA vaccination in patients with prostate cancer using steroids

• Published in: Urologic oncology 2022-10, Vol.40 (10), p.451.e1-451.e8
• Main Authors: Ishii, Noritaka, Hatakeyama, Shingo, Yoneyama, Tohru, Tanaka, Ryuma, Narita, Takuma, Fujita, Naoki, Okamoto, Teppei, Yamamoto, Hayato, Yoneyama, Takahiro, Hashimoto, Yasuhiro, Ohyama, Chikara
• Format: Article
• Language: English
• Subjects: Antibodies, Viral - metabolism; BNT162 Vaccine; Castration-resistant; Clinical-Prostate cancer; COVID-19 - prevention & control; COVID-19 Vaccines; Cross-Sectional Studies; Humans; Immunoglobulin G; Male; mRNA Vaccines; Prostatic Neoplasms, Castration-Resistant; PSARS-CoV-2; RNA, Messenger; SARS-CoV-2; Steroids; Vaccination; Vaccine; Vaccines, Synthetic
• ISSN: 1078-1439; 1873-2496
• DOI: 10.1016/j.urolonc.2022.07.015

•The effect of concomitant steroid use on the antibody response to a SARS-CoV-2 vaccine in patients with prostate cancer remains unknown.•This cross-sectional study included 215 patients with PC who received the second dose of the BNT162b2 mRNA vaccine.•We compared the rate of anti-SARS-CoV-2 spike protein IgG ≥15 U/mL between patients with or without concomitant steroid use.•The humoral response to the BNT162b2 mRNA vaccine was significantly lower in patients with concomitant steroid use.•Anti-SARS-CoV-2 S antibody titers was affected by CRPC status, the accumulation of post-CRPC treatments, and steroid use. The effect of concomitant steroid use on the antibody response to a SARS-CoV-2 vaccine in patients with prostate cancer (PC) remains unknown. We aimed to evaluate the rates of antispike immunoglobulin G (IgG) antibody response to the BNT162b2 mRNA vaccine in patients with PC using steroids. This cross-sectional study conducted from June 21, 2021 to January 5, 2022 included 215 patients with PC who received the second dose of the BNT162b2 mRNA vaccine at least 7 days before the measurement of titers of IgG antibodies against the receptor-binding domain of SARS-CoV-2 spike (S) protein. We compared the rate of anti-SARS-CoV-2 S IgG ≥15 U/mL between patients with or without concomitant steroid use. Of 215, we identified 33 patients who had concomitant steroid use. Of these, 12 and 21 patients were metastatic castration-sensitive PC and castration-resistant PC (CRPC), respectively. Patients with concomitant steroid use had a significantly lower rate of antibody titer ≥15 U/mL than those without steroid use (82% vs. 95%, P = 0.021). Patients with CRPC with concomitant steroid use (n =21) also had a lower rate of antibody titer ≥15 U/mL (71%) than those without steroid use (93%, P = 0.051), although this was not statistically different. Increased number of systemic treatments administered after diagnosis of CRPC (3 lines or more) were significantly associated with antibody titers