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在接受抗癌治疗的肺癌患者中 COVID-19 疫苗的免疫原性和安全性:一项前瞻性多中心队列研究。

Immunogenicity and safety of COVID-19 vaccine in lung cancer patients receiving anticancer treatment: A prospective multicenter cohort study.

机构信息

Department of Pulmonology, Kameda Medical Center, Kamogawa, Chiba, Japan.

Department of Pulmonology, Chikamori Hospital, Kochi, Japan.

出版信息

Hum Vaccin Immunother. 2022 Nov 30;18(6):2140549. doi: 10.1080/21645515.2022.2140549. Epub 2022 Nov 11.

Abstract

This study assessed the immunogenicity and safety of the BNT162b2 mRNA vaccine in lung cancer patients receiving anticancer treatment. We enrolled lung cancer patients receiving anticancer treatment and non-cancer patients; all participants were fully vaccinated with the BNT162b2 vaccine. Blood samples were collected before the first and second vaccinations and 4 ± 1 weeks after the second vaccination. Anti-severe respiratory syndrome coronavirus-2 (SARS-CoV-2) spike protein S1 subunit receptor-binding domain antibody titers were measured using the Architect SARS-CoV-2 IgG II Quant and Elecsys Anti-SARS-CoV-2 S assays. Fifty-five lung cancer patients and 38 non-cancer patients were included in the immunogenicity analysis. Lung cancer patients showed significant increase in the geometric mean antibody concentration, which was significantly lower than that in the non-cancer patients after the first (30 vs. 121 AU/mL,  < .001 on Architect; 4.0 vs 1.2 U/mL,  < .001 on Elecsys) and second vaccinations (1632 vs. 3472 AU/mL,  = .005 on Architect; 213 vs 573 A/mL,  = .002 on Elecsys). The adjusted odds ratio (aOR) for seroprotection was significantly lower ( < .05) in lung cancer patients than that in non-cancer patients. Analysis of the anticancer treatment types showed that the aOR for seroprotection was significantly lower ( < .05) in lung cancer patients receiving cytotoxic agents. They showed no increase in adverse reactions. BNT162b2 vaccination in lung cancer patients undergoing anticancer treatment significantly increased ( < .05) antibody titers and showed acceptable safety. Immunogenicity in these patients could be inadequate compared with that in non-cancer patients.

摘要

本研究评估了接受抗癌治疗的肺癌患者中 BNT162b2 mRNA 疫苗的免疫原性和安全性。我们纳入了正在接受抗癌治疗的肺癌患者和非癌症患者;所有参与者均完成了 BNT162b2 疫苗的全程接种。在第一次和第二次接种前以及第二次接种后 4 ± 1 周采集血样。使用 Architect SARS-CoV-2 IgG II Quant 和 Elecsys Anti-SARS-CoV-2 S 检测试剂盒测定抗严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)刺突蛋白 S1 亚单位受体结合域抗体滴度。55 例肺癌患者和 38 例非癌症患者纳入免疫原性分析。肺癌患者的几何平均抗体浓度显著增加,但第一次(30 与 121 AU/mL,Architect 上  < .001;4.0 与 1.2 U/mL,Elecsys 上  < .001)和第二次(1632 与 3472 AU/mL,Architect 上  = .005;213 与 573 A/mL,Elecsys 上  = .002)接种后,其抗体浓度显著低于非癌症患者。血清保护的调整后比值比(aOR)在肺癌患者中明显低于( < .05)非癌症患者。对抗癌治疗类型的分析表明,接受细胞毒性药物治疗的肺癌患者血清保护的 aOR 明显较低( < .05)。他们没有增加不良反应。在接受抗癌治疗的肺癌患者中接种 BNT162b2 疫苗显著增加( < .05)抗体滴度,并具有可接受的安全性。与非癌症患者相比,这些患者的免疫原性可能不足。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/311a/9746471/ac17b1a6f74f/KHVI_A_2140549_F0001_B.jpg

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