Antibody testing is effective for identifying patients with cancer who have low levels of protection against SARS-CoV-2, according to research published in JAMA Oncology.
Researchers found that antibody response to vaccination was an independent predictor of breakthrough SARS-CoV-2 infection and COVID-19-related hospitalization.
For this study, the researchers evaluated 4249 antibody test results from 3555 patients with cancer and 294,230 antibody test results from 225,272 patients without cancer.
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The primary outcomes were antibody response and titers, SARS-CoV-2 breakthrough infections, and COVID-19 hospitalization. Infections and hospitalizations were monitored from September 1, 2021, to March 4, 2022.
Among patients with at least 2 COVID-19 vaccine doses, undetectable antibody responses were seen in 4.68% of test results from cancer patients and 0.13% of results from patients without cancer (P <.001).
Patients who received a third vaccine dose had higher mean antibody titers than patients who received 2 doses, both in the cancer cohort (P <.001) and the non-cancer cohort (P <.001).
Among patients with cancer, undetectable antibodies were more common in those with hematologic malignancies (19.23%) than in those with solid tumors (4.23%).
A multivariable analysis showed that antibody response was an independent predictor of breakthrough SARS-CoV-2 infection (adjusted odds ratio [aOR], 3.05; 95% CI, 1.96-4.72; P <.001) and COVID-19-related hospitalization (aOR, 6.48; 95% CI, 3.31-12.67; P <.001).
“This study supports larger evaluations of SARS-CoV-2 antibody testing,” the researchers wrote. “Prevention of SARS-CoV-2 transmission to patients with cancer should be prioritized to minimize impact on cancer treatments and maximize quality of life for individuals with cancer during the ongoing pandemic.”
Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.
Reference
Lee LYW, Tilby M, Starkey T, et al. Association of SARS-CoV-2 spike protein antibody vaccine response with infection severity in patients with cancer: A national COVID cancer cross-sectional evaluation. JAMA Oncol. Published online December 22, 2022. doi:10.1001/jamaoncol.2022.5974
