接受抗癌药物治疗的患者接种 2 或 3 剂 BNT162b2 疫苗后的 SARS-CoV-2 抗体反应。
SARS-CoV-2 Antibody Response to 2 or 3 Doses of the BNT162b2 Vaccine in Patients Treated With Anticancer Agents.
机构信息
University Paris Est Créteil, INSERM U955, IMRB, Créteil, France.
AP-HP, Hôpital Henri Mondor, Service d'oncologie médicale, Créteil, France.
出版信息
JAMA Oncol. 2022 Apr 1;8(4):612-617. doi: 10.1001/jamaoncol.2021.7777.
IMPORTANCE
Patients with solid cancer are more susceptible to develop SARS-CoV-2 infection and severe complications; the immunogenicity in patients treated with anticancer agents remains unknown.
OBJECTIVE
To assess the immune humoral response to 2 or 3 doses of the BNT162b2 (BioNTech; Pfizer) vaccine in patients treated with anticancer agents.
DESIGN, SETTING, AND PARTICIPANTS: A prospective observational cohort study was conducted between February 1 and May 31, 2021. Adults treated with anticancer agents who received 2 or 3 doses of vaccine were included; of these, individuals with a weak humoral response 1 month after the second dose received a third injection.
INTERVENTIONS
Quantitative serologic testing of antibodies specific for SARS-CoV-2 was conducted before vaccination and during follow-up.
MAIN OUTCOMES AND MEASURES
Humoral response was evaluated with a threshold of anti-SARS-CoV-2 spike protein antibody levels at 1000 arbitrary units (AU)/mL to neutralize less-sensitive COVID-19 variants.
RESULTS
Among 163 patients (median [range] age, 66 [27-89] years, 86 men [53%]) with solid tumors who received 2 or 3 doses of vaccine, 122 individuals (75%) were treated with chemotherapy, 15 with immunotherapy (9%), and 26 with targeted therapies (16%). The proportions of patients with an anti-S immunoglobulin G titer greater than 1000 AU/mL were 15% (22 of 145) at the time of the second vaccination and 65% (92 of 142) 28 days after the second vaccination. Humoral response decreased 3 months after the second dose. Treatment type was associated with humoral response; in particular, time between vaccine and chemotherapy did not interfere with the humoral response. Among 36 patients receiving a third dose of vaccine, a serologic response greater than 1000 AU/mL occurred in 27 individuals (75%).
CONCLUSIONS AND RELEVANCE
The results of this cohort study appear to support the use of a third vaccine dose among patients with active cancer treatment for solid tumors.
重要性
患有实体瘤的患者更容易感染 SARS-CoV-2 并出现严重并发症；接受抗癌药物治疗的患者的免疫原性仍不清楚。
目的
评估接受抗癌药物治疗的患者接受 2 或 3 剂 BNT162b2（BioNTech；辉瑞）疫苗后的体液免疫反应。
设计、设置和参与者：这是一项于 2021 年 2 月 1 日至 5 月 31 日进行的前瞻性观察队列研究。纳入接受抗癌药物治疗并接受 2 或 3 剂疫苗的成年人；其中，第二剂后 1 个月体液反应较弱的个体接受了第三剂注射。
干预措施
在接种疫苗前和随访期间进行针对 SARS-CoV-2 刺突蛋白的抗体的定量血清学检测。
主要结果和测量
使用中和不那么敏感的 COVID-19 变体的抗 SARS-CoV-2 刺突蛋白抗体水平为 1000 个任意单位（AU）的阈值来评估体液反应。
结果
在 163 名接受 2 或 3 剂疫苗的患有实体瘤的患者中（中位[范围]年龄，66[27-89]岁，86 名男性[53%]），122 名患者（75%）接受了化疗，15 名接受了免疫治疗（9%），26 名接受了靶向治疗（16%）。在第二次接种时，抗-S 免疫球蛋白 G 滴度大于 1000 AU/mL 的患者比例为 15%（22/145），第二次接种后 28 天为 65%（92/142）。第二次接种后 3 个月，体液反应下降。治疗类型与体液反应相关；特别是，疫苗和化疗之间的时间并不干扰体液反应。在接受第三剂疫苗的 36 名患者中，27 名患者（75%）出现大于 1000 AU/mL 的血清学反应。
结论和相关性
这项队列研究的结果似乎支持在接受实体瘤积极治疗的癌症患者中使用第三剂疫苗。
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