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. 

Continue Reading

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.


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