SARS-CoV2 mortality rates are significantly higher in patients with lung cancer compared with the general population. However, little is known on their immunization status after vaccination.
We obtained antibody titers against SARS-CoV2 spike protein from patients with lung cancer both at baseline and at different time points after the first dose of SARS-CoV2 vaccine (three weeks – one week [T1], six weeks ± one week [T2], 12 weeks ± three weeks [T3], and 24 weeks ± three weeks [T4]). Antibody titers were correlated with different clinicopathologic characteristics. Then, they were compared to a control cohort of non-lung cancer patients (Cohort A) as well as a second cohort containing healthy controls (Cohort B) at all time points and at T4, respectively. The t test or one-way analysis of variance was used to compare the means between two or more groups, respectively. All hypothesis testing was performed at a two-sided significance level of α equal to 0.05.
A total of 125 patients with lung cancer were included in the analysis (96 males [74.3%], median age of 68 years [46-91]). All study participants received two vaccine doses (BNT162b2, mRNA-1273, AZD1222). Analysis of anti-SARS-CoV2 spike protein titers showed minimal serum response at T1 (0.4 [0.4-48.6] IU/ml). Antibody response peaked at T2 (527.0 [0.4 – 2500] IU/ml) and declined over T3 (323.0 [0.4-2500] IU/ml) and T4 (141.0 [0.4-2500] IU/ml). Active smokers had lower antibody titers at T2 (p=0.04), T3 (p=0.04), and T4 (p<0.0001) compared with former or never smokers. Peak antibody titers were not associated with any other clinicopathologic characteristics. No significant differences were observed compared with Cohort A. However, lung cancer patients group exhibited significantly decreased antibody titers compared with Cohort B at T4 (p<0.0001).
Lung cancer patients demonstrate sufficient antibody response six weeks after first dose of vaccine against SARS-CoV2 when vaccinated with two dose vaccines. Rapidly declining antibody titers six weeks after first dose underline the need for further studies concerning a third booster dose three months after first dose in patients with lung cancer, and especially active smokers.
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All authors have declared no conflicts of interest.