Division of Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Medical Oncology Outpatient Clinic, Maharaj Nakorn Chiang Mai Hospital, Chiang Mai University, Chiang Mai, Thailand.
PLoS One. 2024 Nov 7;19(11):e0310781. doi: 10.1371/journal.pone.0310781. eCollection 2024.
The aim of this study was to assess the seroconversion rate and percent inhibition of neutralizing antibodies against the wild-type and Omicron variants of SARS-CoV-2 in patients with solid cancer who received two COVID-19 vaccine doses by comparing chemotherapy and nonchemotherapy groups.
This prospective cohort study enrolled 115 cancer patients from Maharaj Nakorn Chiang Mai Hospital, Sriphat Medical Center, Faculty of Medicine, Chiang Mai University, and Chiang Mai Klaimor Hospital, Chiang Mai, Thailand, between August 2021 and February 2022, with data from 91 patients who received two COVID-19 vaccine doses analyzed. Participants received vaccines as part of their personal vaccination programs, including various mRNA and non-mRNA vaccine combinations. Blood samples were collected at baseline, on day 28, and at 6 months post-second dose to assess neutralizing antibodies. The primary outcome was the seroconversion rate against the wild-type and Omicron variants on day 28. Secondary outcomes included seroconversion at 6 months, factors associated with seroconversion, and safety.
Among the participants, 45% were receiving chemotherapy. On day 28, seroconversion rates were 77% and 62% for the wild-type and Omicron variants, respectively. Chemotherapy did not significantly affect seroconversion rates (p = 0.789 for wild type, p = 0.597 for Omicron). The vaccine type administered was positively correlated with seroconversion, with an adjusted odds ratio (95% confidence interval) of 25.86 (1.39-478.06) for the wild type and 17.38 (3.65-82.66) for the Omicron variant with the primary heterologous vaccine regimen. Grades 1 and 2 adverse events were observed in 34.0% and 19.7% of participants, respectively.
Despite the lower seroconversion rate against the Omicron variant, no significant difference was observed between the chemotherapy and nonchemotherapy groups. COVID-19 vaccinations demonstrated good tolerability in this cohort. These findings highlight the importance of vaccine safety and immunogenicity in cancer patients and can inform tailored vaccination strategies for this vulnerable population.
本研究旨在通过比较化疗组和非化疗组，评估接受两剂 COVID-19 疫苗的实体瘤患者对野生型和奥密克戎变异株 SARS-CoV-2 的血清转化率和中和抗体抑制率。
本前瞻性队列研究纳入了 2021 年 8 月至 2022 年 2 月期间来自泰国清迈玛哈沙拉坎那空医院、诗丽吉王后医院、清迈大学医学院和清迈 Klaimor 医院的 115 名癌症患者，其中对 91 名接受两剂 COVID-19 疫苗的患者的数据进行了分析。参与者接受疫苗接种是作为其个人疫苗接种计划的一部分，包括各种 mRNA 和非 mRNA 疫苗组合。在基线、第 28 天和第二次接种后 6 个月采集血样，以评估中和抗体。主要结局是第 28 天对野生型和奥密克戎变异株的血清转化率。次要结局包括 6 个月时的血清转化率、与血清转化率相关的因素以及安全性。
在参与者中，45%正在接受化疗。第 28 天，野生型和奥密克戎变异株的血清转化率分别为 77%和 62%。化疗对血清转化率没有显著影响（野生型 p = 0.789，奥密克戎 p = 0.597）。接种疫苗的类型与血清转化率呈正相关，与主要异源疫苗方案相比，野生型的调整优势比（95%置信区间）为 25.86（1.39-478.06），奥密克戎为 17.38（3.65-82.66）。分别有 34.0%和 19.7%的参与者出现 1 级和 2 级不良事件。
尽管对奥密克戎变异株的血清转化率较低，但化疗组和非化疗组之间未观察到显著差异。本队列中 COVID-19 疫苗具有良好的耐受性。这些发现强调了癌症患者疫苗安全性和免疫原性的重要性，并为这一脆弱人群提供了有针对性的疫苗接种策略。
