Immune response against the SARS-CoV-2 spike protein in cancer patients after COVID-19 vaccination during the Omicron wave: a prospective study

IF 4.7 3区 医学 Q1 INFECTIOUS DISEASES Journal of Infection and Public Health Pub Date : 2024-06-07 DOI:10.1016/j.jiph.2024.102473
María José Muñoz-Gómez , Pablo Ryan , Marta Quero-Delgado , María Martin-Vicente , Guillermo Cuevas , Jorge Valencia , Eva Jiménez , Natalia Blanca-López , Miguel Ángel Lara-Álvarez , José Ángel Hernández-Rivas , Gerardo Redondo , Vicente Mas , Daniel Sepúlveda-Crespo , Mónica Vázquez , Juan Torres-Macho , Isidoro Martínez , Salvador Resino
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Abstract

Background

Cancer patients often have weakened immune systems, resulting in a lower response to vaccines, especially those receiving immunosuppressive oncological treatment (OT). We aimed to assess the impact of OT on the humoral and T-cell response to the B.1 lineage and Omicron variant following COVID-19 vaccination in patients with solid and hematological neoplasms.

Methods

We conducted a prospective study on cancer patients, stratified into OT and non-OT groups, who received a two-dose series of the COVID-19 mRNA vaccine and a booster six months later. The outcomes measured were the humoral (anti-SARS-CoV-2 S IgG titers and ACE2-S interaction inhibition capacity) and cellular (SARS-CoV-2 S-specific T-cell spots per million PBMCs) responses against the B.1 lineage and Omicron variant. These responses were evaluated four weeks after the second dose (n = 98) and eight weeks after the booster dose (n = 71).

Results

The humoral response after the second vaccine dose against the B.1 lineage and Omicron variant was significantly weaker in the OT group compared to the non-OT group (q-value<0.05). A booster dose of the mRNA-1273 vaccine significantly improved the humoral response in the OT group, making it comparable to the non-OT group. The mRNA-1273 vaccine, designed for the original Wuhan strain, elicited a weaker humoral response against the Omicron variant compared to the B.1 lineage, regardless of oncological treatment or vaccine dose. In contrast, T-cell responses against SARS-CoV-2, including the Omicron variant, were already present after the second vaccine dose and were not significantly affected by oncological treatments.

Conclusions

Cancer patients, particularly those receiving immunosuppressive oncological treatments, should require booster doses and adapted COVID-19 vaccines for new SARS-CoV-2 variants like Omicron. Future studies should evaluate the durability of the immune response and the efficacy of individualized regimens.

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一项前瞻性研究:Omicron 浪潮期间癌症患者接种 COVID-19 疫苗后对 SARS-CoV-2 穗状蛋白的免疫反应。
背景:癌症患者的免疫系统通常较弱,因此对疫苗的反应较低,尤其是接受免疫抑制性肿瘤治疗(OT)的患者。我们旨在评估OT对实体瘤和血液肿瘤患者接种COVID-19疫苗后B.1系和Omicron变体的体液和T细胞反应的影响:我们对癌症患者进行了一项前瞻性研究,这些患者被分为OT组和非OT组,他们接种了两剂COVID-19 mRNA疫苗,并在6个月后接种了加强剂。测量的结果是针对 B.1 系和 Omicron 变种的体液反应(抗 SARS-CoV-2 S IgG 滴度和 ACE2-S 相互作用抑制能力)和细胞反应(每百万 PBMCs 中的 SARS-CoV-2 S 特异性 T 细胞点)。这些反应分别在第二剂疫苗接种四周后(98 人)和加强剂接种八周后(71 人)进行了评估:结果:接种第二剂疫苗后,OT 组对 B.1 系和 Omicron 变体的体液反应明显弱于非 OT 组(q-value):癌症患者,尤其是接受免疫抑制性肿瘤治疗的患者,应针对新的 SARS-CoV-2 变种(如 Omicron)接种加强剂量和经调整的 COVID-19 疫苗。未来的研究应评估免疫反应的持久性和个体化治疗方案的疗效。
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来源期刊
Journal of Infection and Public Health
Journal of Infection and Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES
CiteScore
13.10
自引率
1.50%
发文量
203
审稿时长
96 days
期刊介绍: The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other. The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners. It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.
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