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Nguyen · 05-29-2022, 03:30 PM

Efficacy and impact of SARS-CoV-2 vaccination on cancer treatment for patients with breast cancer: A multicenter, prospective, observational study.

https://meetings.asco.org/abstracts-...tations/209998

Mitsuo Terada

Department of Breast Surgery, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan

Mitsuo Terada, Naoto Kondo, Yumi Wanifuchi-Endo, Takashi Fujita, Tomoko Asano, Yasuaki Uemoto, Tomoka Hisada, Akiko Kato, Natsumi Yamanaka, Hiroshi Sugiura, Keiko Mita, Asaka Wada, Eriko Takahashi, Kanako Saito, Ryo Yoshioka, Tatsuya Toyama
Organizations

Department of Breast Surgery, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan, Department of Breast Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan, Departments of Breast Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan, Departments of Breast Surgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Japan, Education and Research Center for Advanced Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan, Department of Surgery, Surgical Oncology and Science, Sapporo Medical University, Sapporo, Japan, Department of Breast and Endocrine Surgery, Akita University Hospital, Akita, Japan, Department of Hematology/Oncology, Mie University Hospital, Tsu, Japan, Department of General Thoracic Surgery and Breast and Endocrine Surgery, Okayama University Graduate School of Medicine, Okayama, Japan
Abstract Disclosures
Research Funding

No funding received

Background:

Vaccination is an essential strategy to prevent infection in the SARS-CoV-2 pandemic. However, there are concerns about vaccine efficacy and the impact of vaccination on cancer treatment. Additionally, the emergence of novel variants may affect vaccination efficacy. This multi-center, prospective, observational study investigated the efficacy and impact of vaccination against SARS-CoV-2 variants on treatment among breast cancer patients in Japan.

Methods:
Breast cancer patients scheduled to be vaccinated with the SARS-CoV-2 vaccine from May to November 2021 were included. They were stratified into five groups according to their cancer treatment: no treatment, endocrine therapy, CDK4/6 inhibitor, chemotherapy, anti-HER2 therapy. Serum samples were collected before the first vaccination and after the second vaccination. Immunoglobulin (Ig)G levels against the SARS-CoV-2 S protein and neutralizing antibody titers against wild-type (WT), alpha (α), delta (δ), kappa (κ), and omicron (ο) variants were measured by ELISA assay. The effect of vaccination on cancer treatment was also investigated.

Results:
There were 85 eligible patients (no treatment, n = 5; endocrine therapy, n = 30; CDK4/6 inhibitor, n = 14; chemotherapy, n = 21; and anti-HER2 therapy, n = 15) with a median age of 65 years. The overall seroconversion rate of anti-SARS-CoV-2 IgG was 95.3%. The seroconversion rate of the chemotherapy group was 81.8%. The anti-SARS-CoV-2 IgG antibody concentration was positively correlated with the lymphocyte count before vaccination (r = 0.232, p = 0.039). Overall neutralizing antibody titers against each variant were significantly lower than for WT. Overall positive rates of neutralizing antibodies against WT, α, δ, κ, and ο variants were 90.2%, 81.7%, 96.3%, 84.1%, and 8.5%, respectively. A downward trend of neutralizing antibody titers against each variant was seen in chemotherapy and CDK4/6 inhibitor groups compared with other groups. Significant decreases were detected in neutralizing antibody titers against WT, α, and κ variants in the chemotherapy group, and WT and α variants in the CDK4/6 inhibitor group compared with the no treatment group. Withdrawal or postponement of systemic therapy because of vaccination was only observed in one patient.

Conclusions:
Our data support SARS-CoV-2 vaccination for cancer patients being treated with systemic therapy. However, neutralizing antibody titers against the ο variant were very low even after two vaccinations among patients with or without cancer treatment. Further, a decrease in neutralizing antibody titer was suggested during chemotherapy and CDK4/6 inhibitor, raising concerns about the impact on long-term infection prevention. For these patients, infection-preventive behaviors should be recommended even after vaccination. They will also be good candidates for booster vaccinations.
Clinical trial information: UMIN000045527.

05-29-2022, 03:30 PM	#15
Nguyen Senior Member Join Date: Nov 2005 Posts: 513	Efficacy and impact of SARS-CoV-2 vaccination on cancer treatment for patients with b Efficacy and impact of SARS-CoV-2 vaccination on cancer treatment for patients with breast cancer: A multicenter, prospective, observational study. https://meetings.asco.org/abstracts-...tations/209998 Mitsuo Terada Department of Breast Surgery, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan Mitsuo Terada, Naoto Kondo, Yumi Wanifuchi-Endo, Takashi Fujita, Tomoko Asano, Yasuaki Uemoto, Tomoka Hisada, Akiko Kato, Natsumi Yamanaka, Hiroshi Sugiura, Keiko Mita, Asaka Wada, Eriko Takahashi, Kanako Saito, Ryo Yoshioka, Tatsuya Toyama Organizations Department of Breast Surgery, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan, Department of Breast Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan, Departments of Breast Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan, Departments of Breast Surgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Japan, Education and Research Center for Advanced Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan, Department of Surgery, Surgical Oncology and Science, Sapporo Medical University, Sapporo, Japan, Department of Breast and Endocrine Surgery, Akita University Hospital, Akita, Japan, Department of Hematology/Oncology, Mie University Hospital, Tsu, Japan, Department of General Thoracic Surgery and Breast and Endocrine Surgery, Okayama University Graduate School of Medicine, Okayama, Japan Abstract Disclosures Research Funding No funding received Background: Vaccination is an essential strategy to prevent infection in the SARS-CoV-2 pandemic. However, there are concerns about vaccine efficacy and the impact of vaccination on cancer treatment. Additionally, the emergence of novel variants may affect vaccination efficacy. This multi-center, prospective, observational study investigated the efficacy and impact of vaccination against SARS-CoV-2 variants on treatment among breast cancer patients in Japan. Methods: Breast cancer patients scheduled to be vaccinated with the SARS-CoV-2 vaccine from May to November 2021 were included. They were stratified into five groups according to their cancer treatment: no treatment, endocrine therapy, CDK4/6 inhibitor, chemotherapy, anti-HER2 therapy. Serum samples were collected before the first vaccination and after the second vaccination. Immunoglobulin (Ig)G levels against the SARS-CoV-2 S protein and neutralizing antibody titers against wild-type (WT), alpha (α), delta (δ), kappa (κ), and omicron (ο) variants were measured by ELISA assay. The effect of vaccination on cancer treatment was also investigated. Results: There were 85 eligible patients (no treatment, n = 5; endocrine therapy, n = 30; CDK4/6 inhibitor, n = 14; chemotherapy, n = 21; and anti-HER2 therapy, n = 15) with a median age of 65 years. The overall seroconversion rate of anti-SARS-CoV-2 IgG was 95.3%. The seroconversion rate of the chemotherapy group was 81.8%. The anti-SARS-CoV-2 IgG antibody concentration was positively correlated with the lymphocyte count before vaccination (r = 0.232, p = 0.039). Overall neutralizing antibody titers against each variant were significantly lower than for WT. Overall positive rates of neutralizing antibodies against WT, α, δ, κ, and ο variants were 90.2%, 81.7%, 96.3%, 84.1%, and 8.5%, respectively. A downward trend of neutralizing antibody titers against each variant was seen in chemotherapy and CDK4/6 inhibitor groups compared with other groups. Significant decreases were detected in neutralizing antibody titers against WT, α, and κ variants in the chemotherapy group, and WT and α variants in the CDK4/6 inhibitor group compared with the no treatment group. Withdrawal or postponement of systemic therapy because of vaccination was only observed in one patient. Conclusions: Our data support SARS-CoV-2 vaccination for cancer patients being treated with systemic therapy. However, neutralizing antibody titers against the ο variant were very low even after two vaccinations among patients with or without cancer treatment. Further, a decrease in neutralizing antibody titer was suggested during chemotherapy and CDK4/6 inhibitor, raising concerns about the impact on long-term infection prevention. For these patients, infection-preventive behaviors should be recommended even after vaccination. They will also be good candidates for booster vaccinations. Clinical trial information: UMIN000045527.