TY - JOUR
T1 - Booster doses of COVID-19 vaccines for patients with haematological and solid cancer
T2 - a systematic review and individual patient data meta-analysis
AU - Mai, Aaron Shengting
AU - Lee, Ainsley Ryan Yan Bin
AU - Tay, Ryan Yong Kiat
AU - Shapiro, Lauren
AU - Thakkar, Astha
AU - Halmos, Balazs
AU - Grinshpun, Albert
AU - Herishanu, Yair
AU - Benjamini, Ohad
AU - Tadmor, Tamar
AU - Shroff, Rachna T.
AU - LaFleur, Bonnie J.
AU - Bhattacharya, Deepta
AU - Peng, Siyu
AU - Tey, Jeremy
AU - Lee, Soo Chin
AU - Chai, Louis Yi Ann
AU - Soon, Yu Yang
AU - Sundar, Raghav
AU - Lee, Matilda Xinwei
N1 - Funding Information:
The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: YYS—honoraria (AstraZeneca); RS—honoraria (MSD, Eli Lilly, BMS, Roche, Taiho, Astra Zeneca, DKSH), consulting or advisory role (Bristol Myers Squibb, Merck, Eisai, Bayer, Taiho, Novartis, MSD, GSK), research funding (Paxman Coolers, MSD), travel (Roche, Astra Zeneca, Taiho, Eisai, DKSH). DB—Sana Biotechnology has licensed intellectual property of DB and Washington University in St. Louis. Gilead Biosciences has licensed intellectual property of D.B. and Stanford University. DB is a co-founder of Clade Therapeutics. DB serves on a COVID-19 therapeutics advisory panel for GlaxoSmithKline. BJL—has a financial interest in Cofactor Genomics, Inc. and Iron Horse Dx. RTS—receives research funding from Merck, Rafael Pharmaceuticals, ImmunoVaccine, Bayer, SeaGen, Exelixis, Pieris, LOXO Oncology, Novocure, NuCana, QED and has served as a consultant/advisor to Merck, Servier, Astra-Zeneca, EMD Serono, Taiho, QED, Incyte, Genentech, Basilea. YH—Honoraria from ABBVIE, Janssen, Astra-Zeneca, Roche and Medison, all outside of the submitted work. All other authors have no conflicts of interest to declare.
Funding Information:
RS is supported by the National Medical Research Council ( NMRC/MOH/000627 ).
Publisher Copyright:
© 2022 Elsevier Ltd
PY - 2022/9
Y1 - 2022/9
N2 - Importance: Patients with cancer have an increased risk of severe disease and mortality from COVID-19, as the disease and antineoplastic therapy cause reduced vaccine immunogenicity. Booster doses have been proposed to enhance protection, and efficacy data are emerging from several studies. Objective: To evaluate the proportion of COVID-19 primary vaccination non-responders with cancer who seroconvert after a booster dose. Methods: PubMed, EMBASE, CENTRAL and medRxiv were searched from 1st January 2021 to 10th March 2022. Quality was assessed using the Joanna Briggs Institute Critical Appraisal checklist. Results: After the eligibility assessment, 22 studies were included in this systematic review and 17 for meta-analysis of seroconversion in non-responders, pooling a total of 849 patients with haematological cancer and 82 patients with solid cancer. Haematological cancer non-responders exhibited lower seroconversion at 44% (95% CI 36–53%) than solid cancer at 80% (95% CI 69–87%). Individual patient data meta-analysis found the odds of having a meaningful rise in antibody titres to be significantly associated with increased duration between the second and third dose (OR 1.02, 95% CI 1.00–1.03, P ≤ 0.05), age of patient (OR 0.960, 95% CI 0.934–0.987, P ≤ 0.05) and cancer type. With patients with haematological cancer as a reference, patients with lung cancer had 16.8 times the odds of achieving a meaningful increase in antibody titres (OR 16.8, 95% CI 2.95–318, P ≤ 0.05) and gastrointestinal cancer patients had 25.4 times the odds of achieving a meaningful increase in antibody titres (OR 25.4, 95% CI 5.26–492.21, P ≤ 0.05). Conclusions: administration of a COVID-19 vaccine booster dose is effective in improving seroconversion and antibody levels. Patients with haematological cancer consistently demonstrate poorer response to booster vaccines than patients with solid cancer.
AB - Importance: Patients with cancer have an increased risk of severe disease and mortality from COVID-19, as the disease and antineoplastic therapy cause reduced vaccine immunogenicity. Booster doses have been proposed to enhance protection, and efficacy data are emerging from several studies. Objective: To evaluate the proportion of COVID-19 primary vaccination non-responders with cancer who seroconvert after a booster dose. Methods: PubMed, EMBASE, CENTRAL and medRxiv were searched from 1st January 2021 to 10th March 2022. Quality was assessed using the Joanna Briggs Institute Critical Appraisal checklist. Results: After the eligibility assessment, 22 studies were included in this systematic review and 17 for meta-analysis of seroconversion in non-responders, pooling a total of 849 patients with haematological cancer and 82 patients with solid cancer. Haematological cancer non-responders exhibited lower seroconversion at 44% (95% CI 36–53%) than solid cancer at 80% (95% CI 69–87%). Individual patient data meta-analysis found the odds of having a meaningful rise in antibody titres to be significantly associated with increased duration between the second and third dose (OR 1.02, 95% CI 1.00–1.03, P ≤ 0.05), age of patient (OR 0.960, 95% CI 0.934–0.987, P ≤ 0.05) and cancer type. With patients with haematological cancer as a reference, patients with lung cancer had 16.8 times the odds of achieving a meaningful increase in antibody titres (OR 16.8, 95% CI 2.95–318, P ≤ 0.05) and gastrointestinal cancer patients had 25.4 times the odds of achieving a meaningful increase in antibody titres (OR 25.4, 95% CI 5.26–492.21, P ≤ 0.05). Conclusions: administration of a COVID-19 vaccine booster dose is effective in improving seroconversion and antibody levels. Patients with haematological cancer consistently demonstrate poorer response to booster vaccines than patients with solid cancer.
KW - COVID-19
KW - COVID-19 vaccine
KW - haematological cancer
KW - immunocompromise
KW - solid cancer
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U2 - 10.1016/j.ejca.2022.05.029
DO - 10.1016/j.ejca.2022.05.029
M3 - Review article
C2 - 35753213
AN - SCOPUS:85132781586
VL - 172
SP - 65
EP - 75
JO - European Journal of Cancer
JF - European Journal of Cancer
SN - 0959-8049
ER -