Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain.
Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain; Hospital Universitario Infanta Leonor, Madrid, Spain; Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain; Instituto de Investigaciones Sanitarias Gregorio Marañón (IiSGM), Madrid, Spain.
J Infect Public Health. 2024 Jul;17(7):102473. doi: 10.1016/j.jiph.2024.102473. Epub 2024 Jun 7.
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.
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).
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.
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.
癌症患者的免疫系统通常较弱，导致对疫苗的反应降低，尤其是那些接受免疫抑制性肿瘤治疗（OT）的患者。我们旨在评估 OT 对 COVID-19 疫苗接种后实体瘤和血液系统恶性肿瘤患者对 B.1 谱系和奥密克戎变异株的体液和 T 细胞反应的影响。
我们对接受两剂 COVID-19 mRNA 疫苗系列接种并在六个月后加强针的癌症患者进行了一项前瞻性研究，将患者分为 OT 和非 OT 组。测量的结果是针对 B.1 谱系和奥密克戎变异株的体液（抗 SARS-CoV-2 S IgG 滴度和 ACE2-S 相互作用抑制能力）和细胞（每百万 PBMCs 中的 SARS-CoV-2 S 特异性 T 细胞斑点）反应。这些反应在第二次剂量后四周（n=98）和加强剂量后八周（n=71）进行评估。
OT 组在第二次疫苗接种后针对 B.1 谱系和奥密克戎变异株的体液反应明显弱于非 OT 组（q 值<0.05）。mRNA-1273 疫苗的加强剂量显著改善了 OT 组的体液反应，使其与非 OT 组相当。mRNA-1273 疫苗针对原始武汉株设计，与 B.1 谱系相比，针对奥密克戎变异株的体液反应较弱，无论肿瘤治疗或疫苗剂量如何。相比之下，针对 SARS-CoV-2 的 T 细胞反应，包括奥密克戎变异株，在第二次疫苗接种后就已经存在，并且不受肿瘤治疗的显著影响。
癌症患者，特别是那些接受免疫抑制性肿瘤治疗的患者，应该需要加强剂量和针对奥密克戎等新 SARS-CoV-2 变异株的适应性 COVID-19 疫苗。未来的研究应该评估免疫反应的持久性和个体化方案的疗效。
