Adaptive immunity and neutralizing antibodies against SARS-CoV-2 variants of concern following vaccination in patients with cancer: the CAPTURE study
Annika Fendler, Scott T.C. Shepherd, Lewis Au, Katalin A. Wilkinson, Mary Wu, Fiona Byrne, Maddalena Cerrone, Andreas M. Schmitt, Nalinie Joharatnam‐Hogan, Benjamin Shum, Zayd Tippu, Karolina Rzeniewicz, Laura Amanda Boos, Ruth Harvey, Eleanor Carlyle, Kim Edmonds, Lyra Del Rosario, Sarah Sarker, Karla Lingard, Mary Mangwende, Lucy Holt, Hamid Ahmod, Justine Korteweg, Tara Foley, Jessica Bazin, William Gordon, Taja Barber, Andrea Emslie-Henry, Wenyi Xie, Camille L. Gérard, Daqi Deng, Emma Wall, Ana Agua‐Doce, Sina Namjou, Simon Caidan, Mike Gavrielides, James I. MacRae, Gavin Kelly, Kema Peat, Denise Kelly, Aida Murra, Kayleigh Kelly, Molly O’Flaherty, Lauren Dowdie, Natalie Ash, Firza Alexander Gronthoud, Robyn Shea, Gail Gardner, Darren R. Murray, Fiona Kinnaird, Wanyuan Cui, Javier Pascual, Simon Rodney, Justin Mencel, Olivia Curtis, Clemency Stephenson, Anna Robinson, Bhavna Oza, Sheima Farag, Isla Leslie, Aljosja Rogiers, Sunil Iyengar, Mark Ethell, Christina Messiou, David Cunningham, Ian Chau, Naureen Starling, Nicholas C. Turner, Liam Welsh, Nicholas van As, Robin L. Jones, Joanne Droney, Susana Banerjee, Kate Tatham, Mary O’Brien, Kevin J. Harrington, Shreerang Bhide, Alicia Okines, Alison Reid, Kate Young, Andrew J.S. Furness, Lisa Pickering, Charles Swanton, Sonia Gandhi, S.J. Gamblin, David L.V. Bauer, George Kassiotis, Sacheen Kumar, Nadia Yousaf, Shaman Jhanji, Emma Nicholson, Michael Howell, Susanna Walker, Robert J. Wilkinson, James Larkin, Samra Turajlic
Abstract
CAPTURE (NCT03226886) is a prospective cohort study of COVID-19 immunity in patients with cancer. Here we evaluated 585 patients following administration of two doses of BNT162b2 or AZD1222 vaccines, administered 12 weeks apart. Seroconversion rates after two doses were 85% and 59% in patients with solid and hematological malignancies, respectively. A lower proportion of patients had detectable neutralizing antibody titers (NAbT) against SARS-CoV-2 variants of concern (VOCs) vs wildtype (WT). Patients with hematological malignancies were more likely to have undetectable NAbT and had lower median NAbT vs solid cancers against both WT and VOCs. In comparison with individuals without cancer, patients with haematological, but not solid, malignancies had reduced NAb responses. Seroconversion showed poor concordance with NAbT against VOCs. Prior SARS-CoV-2 infection boosted NAb response including against VOCs, and anti-CD20 treatment was associated with undetectable NAbT. Vaccine-induced T-cell responses were detected in 80% of patients, and were comparable between vaccines or cancer types. Our results have implications for the management of cancer patients during the ongoing COVID-19 pandemic.