2286P - COVID-19 vaccinations in cancer patients (pts): An individual participant data meta-analysis of the International Consortium on COVID vaccination in cancer

Background

Solid cancer pts are at higher risk of severe COVID-19 compared to the general population, highlighting the importance of effective vaccination for this vulnerable group. However, there is little evidence on how to identify those at risk of an impaired immune response to vaccination among this heterogeneous group.

Methods

This study evaluates the immune response to COVID-19 vaccines in solid cancer pts using individual participant data meta-analysis methods. The study protocol was registered with Prospero CRD42022311290.

Results

We identified 53 eligible prospective cohort studies, investigators of 6 studies agreed to share data, including around 5000 participants with and without cancer. Here, we present the results of the first 1322 participants, of which 247 did not have cancer. Median age was 62 (IQR 55, 70), and 51% were male. Thoracic (18%), breast (17%), and gastrointestinal cancers (15%) were most common. The majority had metastatic disease (54%); 41% received cytotoxic therapy (CT), 26% immune checkpoint inhibitors (ICIs), and 15% targeted therapy (TT) prior to their 1st vaccination. After the 2nd vaccination, 986 pts (75%) had sufficient antibody titres (ABTs) (defined as 300 binding antibody units/mL), while data were missing for 208 (16%). Following the 2nd vaccination, the proportion of cancer pts with sufficient ABTs was lower (88%) compared with individuals without cancer (99.6%), odds ratio (OR) 0.03 (95%CI 0.00, 0.15; p < 0.001). Among cancer pts, those with CT 30 days prior to the 1st vaccination were less likely to have sufficient ABTs (OR 0.61 (95%CI 0.39, 0.94)). There was no such association for treatment with ICIs, TT, monoclonal antibodies, or corticosteroids.

Conclusions

Although most cancer pts develop a sufficient immune response to COVID-19 vaccines, their risk of impaired response is significantly higher than in individuals without cancer. Specifically, pts who received CT within 30 days prior to their 1st vaccination are at higher risk of impaired response, and additional vaccinations may be considered. Results on the association between patient, disease, and treatment characteristics and immune response will be presented at the meeting.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The Francis Crick Institute.

Funding

Has not received any funding.

Disclosure

H.M.L. Le: Financial Interests, Personal, Sponsor/Funding, Sponsor meeting: Pfizer, Novartis. A.M. Schmitt: Financial Interests, Personal, Research Grant: Janssen-Cilag; Financial Interests, Personal, Sponsor/Funding, Conference attendance: Novartis. S. Oosting: Financial Interests, Institutional, Advisory Board: Bristol Myers Squibb, Genmab; Financial Interests, Institutional, Invited Speaker: Merck; Financial Interests, Institutional, Research Grant, Investigator Initiated Research: Celldex; Financial Interests, Institutional, Research Grant, Investigator initiated study: Pfizer, Novartis; Financial Interests, Institutional, Research Grant, I am the principle investigator of EORTC 2120 for which EORTC has received funding from Merck: Merck; Non-Financial Interests, Institutional, Product Samples: Celldex, Pfizer, Novartis; Other, Member of Steering and Safety Monitoring Committee, unpaid: ALX Oncology. A.A.M. Van der Veldt: Financial Interests, Institutional, Other, Consultant: BMS, MSD, Merck, Roche, Novartis, Pfizer, Sanofi, Pierre Fabre, Eisai, Ipsen. K. Reckamp: Financial Interests, Personal, Other, consultant: Amgen, AstraZeneca, Blueprint, Daiichi Sankyo, Genentech, GSK, Janssen, Lilly, Mirati, Takeda; Financial Interests, Personal, Advisory Board: EMD Serono, Merck KGaA; Financial Interests, Personal, Writing Engagement: Seattle Genetics; Financial Interests, Institutional, Local PI: Genentech, Blueprint, Calithera, Daiichi Sankyo, Elevation Oncology, Janssen. J.B.A.G. Haanen: Financial Interests, Institutional, Advisory Board: Bristol Myers Squibb, Achilles Therapeutics, Ipsen, Merck Sharp & Dohme, Merck Serono, Pfizer, Molecular Partners, Novartis, Roche, Sanofi, Third Rock Venture, Iovance Biotherapeutics; Financial Interests, Institutional, Advisory Board, SAB member: BioNTech, Immunocore, Gadeta, Instil Bio, PokeAcel, T-Knife; Financial Interests, Personal, Advisory Board, SAB member: Neogene Therapeutics, Scenic; Financial Interests, Personal, Stocks/Shares: Neogene Therapeutics; Financial Interests, Institutional, Research Grant: Bristol Myers Squibb, BioNTech US, Merck Sharp & Dohme, Amgen, Novartis, Asher Bio; Non-Financial Interests, Member: ASCO, AACR, SITC; Other, Editor-in-Chief IOTECH: ESMO; Other, Editorial Board ESMO Open: ESMO; Other, Editorial Board: Kidney Cancer. E.G.E. de Vries: Financial Interests, Institutional, Advisory Board, Member Data Safety Monitoring Committee: Daiichi Sankyo, NSABP; Financial Interests, Institutional, Advisory Board, Consultant: Crescendo Biologics; Financial Interests, Institutional, Research Grant, (Preclinical) imaging studies with bispecific antibodies: Amgen; Financial Interests, Institutional, Research Grant, Phase I and imaging study with Thorium-labeled antibody: Bayer; Financial Interests, Institutional, Research Grant, Imaging and treatment study with probody: CytomX Therapeutics; Financial Interests, Institutional, Research Grant, Phase I study with hormonal drug: G1 Therapeutics; Financial Interests, Institutional, Research Grant, Imaging studies with CD8 and PD-L1 tracers: Genentech; Financial Interests, Institutional, Research Grant, Imaging and treatment study with CD8 and LAG-3 antibody: Regeneron; Financial Interests, Institutional, Research Grant, Treatment studies with PD-L1 antibody: Roche; Financial Interests, Institutional, Research Grant, Preclinical imaging study and imaging and treatment study with PD-L1x4-1BB bispecific antibody (S095012): Servier; Financial Interests, Institutional, Research Grant, Phase 1-2 and 3 study with ADCs: Synthon; Financial Interests, Institutional, Research Grant, Imaging and treatment with a trispecific humabody T-cell enhancer, CB307: Crescendo Biologics; Non-Financial Interests, Other, 1. Member (current) and Chair (2017-2022) ESMO Cancer Medicines Working Group2. Member (current) and Chair (2013-2021) ESMO-MCBS Working Group: ESMO; Non-Financial Interests, Other, Member supervisory board: Netherlands Comprehensive Cancer Organisation; Non-Financial Interests, Other, Member (current) and Co-chair (2009-2022) RECIST committee: RECIST; Non-Financial Interests, Other, Member expert panel for selection of Essential Medicine List WHO (2019, 2021 and 2023) : WHO; Non-Financial Interests, Other, Chair grant selection committee: Hanarth Fund; Non-Financial Interests, Other, Member of Royal Netherlands Academy of Arts & Sciences (KNAW): Royal Netherlands Academy of Arts & Sciences (KNAW). S. Turajlic: Financial Interests, Personal, Invited Speaker: IDEA Pharma, Roche, Ventana, MSD, Merck; Financial Interests, Institutional, Funding, Uncommon theme pump priming funds: NIHR; Financial Interests, Institutional, Funding, Digital theme funding: RMH/ICR/BRC/Imperial AHSC/Faculty of Medicine; Financial Interests, Institutional, Funding, Tracking renal cancer evolution in blood: Rosetrees Trust; Financial Interests, Institutional, Funding, Clinical PhD Fellowship over 3 years: CRUK Welcome Trust; Financial Interests, Institutional, Funding, Investigating the relationship between primary melanomas and their metastases: The Robert McAlpine Foundation; Financial Interests, Institutional, Funding, Innovation Grant Award for biomarker development: The Francis Crick Institute; Financial Interests, Institutional, Funding, Developing a novel method of representative tumour in sampling in clinical setting: Ventana; Financial Interests, Institutional, Funding, Mapping clonal evolution in renal cell carcinoma: CRUK training and career development board - clinician scientist fellowship; Financial Interests, Institutional, Funding: Harry J Lloyd Charitable Trust Career Development Award; Financial Interests, Institutional, Funding, Clinical Research Fellowship in melanoma: Andy Quick Charitable fund; Financial Interests, Institutional, Funding, Mechanisms of BRAF resistance: Complete Genomics; Financial Interests, Institutional, Funding, Molecular profiling of non-cutaneous melanoma: CRUK; Financial Interests, Institutional, Funding, Target discovery in acral melanoma: Rosetrees Trust. All other authors have declared no conflicts of interest.