Abstract | 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.
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Authors | Aaron Shengting Mai, Ainsley Ryan Yan Bin Lee, Ryan Yong Kiat Tay, Lauren Shapiro, Astha Thakkar, Balazs Halmos, Albert Grinshpun, Yair Herishanu, Ohad Benjamini, Tamar Tadmor, Rachna T Shroff, Bonnie J LaFleur, Deepta Bhattacharya, Siyu Peng, Jeremy Tey, Soo Chin Lee, Louis Yi Ann Chai, Yu Yang Soon, Raghav Sundar, Matilda Xinwei Lee |
Journal | European journal of cancer (Oxford, England : 1990)
(Eur J Cancer)
Vol. 172
Pg. 65-75
(09 2022)
ISSN: 1879-0852 [Electronic] England |
PMID | 35753213
(Publication Type: Journal Article, Meta-Analysis, Review, Systematic Review, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2022 Elsevier Ltd. All rights reserved. |
Chemical References |
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Topics |
- COVID-19
(prevention & control)
- COVID-19 Vaccines
- Hematologic Neoplasms
(therapy)
- Humans
- Immunization, Secondary
- Neoplasms
(therapy)
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