Clinical efficacy and long-term immunogenicity of an early triple dose regimen of SARS-CoV-2 mRNA vaccination in cancer patients.
10.47102/annals-acadmedsg.2022302
- Author:
Matilda Xinwei LEE
1
;
Siyu PENG
;
Ainsley Ryan Yan Bin LEE
;
Shi Yin WONG
;
Ryan Yong Kiat TAY
;
Jiaqi LI
;
Areeba TARIQ
;
Claire Xin Yi GOH
;
Ying Kiat TAN
;
Benjamin Kye Jyn TAN
;
Chong Boon TEO
;
Esther CHAN
;
Melissa OOI
;
Wee Joo CHNG
;
Cheng Ean CHEE
;
Carol L F HO
;
Robert John WALSH
;
Maggie WONG
;
Yan SU
;
Lezhava ALEXANDER
;
Sunil Kumar SETHI
;
Shaun Shi Yan TAN
;
Yiong Huak CHAN
;
Kelvin Bryan TAN
;
Soo Chin LEE
;
Louis Yi Ann CHAI
;
Raghav SUNDAR
Author Information
1. Department of Haematology-Oncology, National University Cancer Institute, Singapore, Singapore.
- Publication Type:Journal Article
- MeSH:
Humans;
SARS-CoV-2;
COVID-19/prevention & control*;
Treatment Outcome;
Neoplasms/drug therapy*;
Hematologic Neoplasms;
Vaccination;
RNA, Messenger;
Antibodies, Viral;
Immunogenicity, Vaccine
- From:Annals of the Academy of Medicine, Singapore
2023;52(1):8-16
- CountrySingapore
- Language:English
-
Abstract:
INTRODUCTION:Three doses of SARS-CoV-2 mRNA vaccines have been recommended for cancer patients to reduce the risk of severe disease. Anti-neoplastic treatment, such as chemotherapy, may affect long-term vaccine immunogenicity.
METHOD:Patients with solid or haematological cancer were recruited from 2 hospitals between July 2021 and March 2022. Humoral response was evaluated using GenScript cPASS surrogate virus neutralisation assays. Clinical outcomes were obtained from medical records and national mandatory-reporting databases.
RESULTS:A total of 273 patients were recruited, with 40 having haematological malignancies and the rest solid tumours. Among the participants, 204 (74.7%) were receiving active cancer therapy, including 98 (35.9%) undergoing systemic chemotherapy and the rest targeted therapy or immunotherapy. All patients were seronegative at baseline. Seroconversion rates after receiving 1, 2 and 3 doses of SARS-CoV-2 mRNA vaccination were 35.2%, 79.4% and 92.4%, respectively. After 3 doses, patients on active treatment for haematological malignancies had lower antibodies (57.3%±46.2) when compared to patients on immunotherapy (94.1%±9.56, P<0.05) and chemotherapy (92.8%±18.1, P<0.05). SARS-CoV-2 infection was reported in 77 (28.2%) patients, of which 18 were severe. No patient receiving a third dose within 90 days of the second dose experienced severe infection.
CONCLUSION:This study demonstrates the benefit of early administration of the third dose among cancer patients.
