Journal Article

Serologic response following SARS-COV2 vaccination in patients with cancer: a systematic review and meta-analysis

Luna, Alexander, Micic, Dejan, Sakuraba, Atsushi

2022

Overview

Purpose Patients with cancer have an increased risk of coronavirus disease 2019 (COVID-19) and an attenuated responses to various vaccines. This meta-analysis aims to assess the serologic response to COVID-19 vaccination in patients with cancer. Methods Electronic databases were systematically searched on August 1, 2021 for studies that reported the serologic response to COVID-19 vaccine in cancer patients. Random effects models were used to achieve pooled serologic response rates and odds ratios (ORs). Results We analyzed 16 observational studies with a total of 1453 patients with cancer. A majority of studies used mRNA vaccines (BNT162b2 or mRNA-1273). The proportion of patients achieving a serologic response after a single and two doses of COVID-19 vaccine were 54.2% (95% confidence interval [CI] 41.0–66.9) and 87.7% (95% CI 82.5–91.5), respectively. Patients with hematologic cancers had a lower response rate after the second dose of vaccine compared to those with solid organ cancers (63.7% vs. 94.9%), which was attributable to the low response rates associated with certain conditions (chronic lymphocytic leukemia, lymphoma) and therapies (anti-CD20, kinase inhibitors). A lower proportion of patients with cancer achieved a serologic response compared to control patients after one and two doses of vaccine (OR0.073 [95% CI 0.026–0.20] and 0.10 [95% CI 0.039–0.26], respectively). Conclusions Patients with cancer, especially those with hematologic B-cell malignancies, have a lower serologic response to COVID-19 vaccines. The results suggest that cancer patients should continue to follow safety measures including mask-wearing after vaccination and suggest the need for additional strategies for prophylaxis.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Analysis / Blood cancer / Blood diseases / Cancer / Cancer patients / Cancer Research / Cancer therapies / Cancer vaccines / Care and treatment / CD20 antigen / Chemotherapy / Chronic lymphocytic leukemia / Coronaviruses / COVID-19 / COVID-19 - blood / COVID-19 - complications / COVID-19 - therapy / COVID-19 - virology / COVID-19 Serological Testing - methods / COVID-19 vaccines / COVID-19 Vaccines - administration & dosage / COVID-19 Vaccines - immunology / Disease prevention / Health aspects / Hematology / Humans / Immunization / Immunocompromised / Leukemia / Lymphatic leukemia / Lymphocytes B / Lymphoma / Lymphomas / Medical diagnosis / Medicine / Medicine & Public Health / Meta-analysis / mRNA / Neoplasms - blood / Neoplasms - immunology / Neoplasms - therapy / Neoplasms - virology / Oncology / Oncology, Experimental / Outcomes / Pandemics / Prognosis / RNA / SARS-CoV-2 - isolation & purification / SARS-CoV-2 - pathogenicity / Sensitivity analysis / Severe acute respiratory syndrome coronavirus 2 / Stem cells / Survival Rate / Systematic review / Transplants & implants / Tumors / Vaccination / Vaccine / Vaccines