A cohort study of antibody response to SARS-CoV-2 mRNA vaccinations in patients with lung cancer was presented at the virtual 2021 World Conference on Lung Cancer. Researchers evaluated reports of high case fatality rates (30-40%) in SARS-CoV-2 infection, and sought to understand whether this patient population expresses weaker antibody response to infection or vaccination in comparison to healthy controls (HCs).

“Using a validated enzyme-linked immunosorbent assay (ELISA) to the full-length spike protein, we found strong responses to infection and a robust neutralizing antibody response to vaccination within several hundred HCs,” explained Jorge E Gomez, MD, Icahn School of Medicine at Mount Sinai, New York, alongside co-investigators.

Researchers developed a control-matched longitudinal study of 750 patients with lung cancer in any stage with or without previous SARS-CoV-2 infection and/or vaccination. Antibody titers were compared at baseline between 3-, 6-, 12-, and 24-month intervals.

“We hypothesized that lung cancer patients have a weaker antibody response to SARS-CoV-2 infection and/or vaccination due to cancer or its treatment compared to matched HCs. The non-parametric Kruskal-Wallis test was used, and if confirmed, a tailored vaccination program would be necessary to ensure immune protection for patients with lung cancer,” continued Dr Gomez, et al.

To date, 111 patients with lung cancer were enrolled, with 78 who received at least one vaccination and 33 unvaccinated. Patients with at least one dose retained a lower median antibody level than partially vaccinated HCs (p=0.01). Fully vaccinated patients had substantial antibody titers but a lower median antibody level than fully vaccinated HCs (p=0.01).

Notably, 30% of partially vaccinated patients did not develop neutralizing antibodies.

There were no discernable differences in median antibody levels in lung cancer patients by gender, smoking status, age, or treatment with or without chemotherapy, immune checkpoint inhibitors, or targeted therapy.

The ongoing study found that more than 70% of lung cancer patients exhibited favorable antibody responses to vaccination. However, a subgroup had significantly lower anti-spike antibody and neutralizing levels compared to HCs.

“Further studies are required to evaluate the role of further boost vaccinations in this patient population with a particular focus on patients not producing neutralizing antibodies to further understand the lack of response,” concluded Dr Gomez, et al. – Alexa Stoia