Adaptive immunity and neutralizing antibodies against SARS-CoV-2 variants of concern following vaccination in patients with cancer: The CAPTURE study

Nat Cancer. 2021 Dec:2:1321-1337. doi: 10.1038/s43018-021-00274-w. Epub 2021 Oct 27.

Abstract

CAPTURE (NCT03226886) is a prospective cohort study of COVID-19 immunity in patients with cancer. Here we evaluated 585 patients following administration of two doses of BNT162b2 or AZD1222 vaccines, administered 12 weeks apart. Seroconversion rates after two doses were 85% and 59% in patients with solid and hematological malignancies, respectively. A lower proportion of patients had detectable neutralizing antibody titers (NAbT) against SARS-CoV-2 variants of concern (VOCs) vs wildtype (WT). Patients with hematological malignancies were more likely to have undetectable NAbT and had lower median NAbT vs solid cancers against both WT and VOCs. In comparison with individuals without cancer, patients with haematological, but not solid, malignancies had reduced NAb responses. Seroconversion showed poor concordance with NAbT against VOCs. Prior SARS-CoV-2 infection boosted NAb response including against VOCs, and anti-CD20 treatment was associated with undetectable NAbT. Vaccine-induced T-cell responses were detected in 80% of patients, and were comparable between vaccines or cancer types. Our results have implications for the management of cancer patients during the ongoing COVID-19 pandemic.

Keywords: Adaptive Immunity; Antibody Response; COVID-19; Cancer; Neutralising Antibodies; Prospective Study; SARS-CoV-2; T-cell Response; Vaccine.

Publication types

  • Clinical Trial
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptive Immunity / immunology*
  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Neutralizing / immunology*
  • BNT162 Vaccine / administration & dosage
  • BNT162 Vaccine / immunology
  • COVID-19 / complications
  • COVID-19 / epidemiology
  • COVID-19 / immunology*
  • COVID-19 Vaccines / administration & dosage
  • COVID-19 Vaccines / immunology*
  • Carcinoma, Renal Cell / complications*
  • ChAdOx1 nCoV-19 / administration & dosage
  • ChAdOx1 nCoV-19 / immunology
  • Female
  • Humans
  • Immunogenicity, Vaccine / immunology
  • Kidney Neoplasms / complications*
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Pandemics / prevention & control
  • Prospective Studies
  • SARS-CoV-2 / genetics
  • SARS-CoV-2 / immunology*
  • SARS-CoV-2 / physiology
  • T-Lymphocytes / immunology
  • T-Lymphocytes / virology
  • Vaccination / methods

Substances

  • Antibodies, Neutralizing
  • COVID-19 Vaccines
  • ChAdOx1 nCoV-19
  • BNT162 Vaccine

Supplementary concepts

  • SARS-CoV-2 variants

Associated data

  • ClinicalTrials.gov/NCT03226886