COVID-19 vaccination does not appear to prevent SARS-CoV-2 infection in patients with lung cancer, but it may prevent severe COVID-19, according to a study presented at the IASLC 2022 World Conference on Lung Cancer.

Researchers observed 16 new SARS-CoV-2 infections and 2 reinfections after vaccination in a cohort of 126 patients. However, most infections were mild, or patients were asymptomatic. There were no deaths attributed to COVID-19. 

The 126 patients were included from March 31, 2021, through May 15, 2021, and followed until June 1, 2022. At baseline, the patients had a median age of 66 (range, 46-83) years. Most patients were men (61.9%), had non-small cell lung cancer (88.1%), and had stage IV disease (76.2%). 


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The anticancer therapies patients received were immunotherapy (35%), chemotherapy (19.8%), tyrosine kinase inhibitors (19.8%), immunotherapy-chemotherapy combinations (14.3%), active surveillance (7.2%), chemoradiotherapy (3.2%), and other treatment (0.8%). 

All 126 patients received at least 1 dose of a COVID-19 vaccine (120 Moderna, 2 Pfizer-BioNTech, and 4 AstraZeneca). One patient died after the first dose, so 125 patients received a second dose (119 Moderna, 2 Pfizer-BioNTech, and 4 AstraZeneca). 

A third dose was given to 96 patients (93 Moderna, 1 Pfizer-BioNTech, and 2 AstraZeneca). Of the patients who did not receive a third dose, 27 had died, and 3 chose not to receive a third dose. 

Results

The researchers performed immunoglobulin G (IgG) antibody testing before vaccination, at 3-6 months, at 7-9 months, and at 12-15 months after the first vaccine dose.

There were 122 baseline blood samples. This group included 4 patients who had a documented SARS-CoV-2 infection prior to vaccination and were IgG positive at baseline, 3 patients who had a documented infection but were IgG negative at baseline, and 9 patients who were IgG positive at baseline but did not have a documented infection prior to vaccination. 

The remaining 106 patients were IgG negative at baseline and had no prior documented infection. All but 1 patient seroconverted after the first or second vaccine dose.

There was 1 patient who had a SARS-CoV-2 infection after the first vaccine dose, 5 patients who were infected after the second dose, and 10 patients who were infected after the third dose. Two cases of reinfection occurred after the third dose as well. 

Most patients had asymptomatic or mild COVID-19. None of the deaths in this study were thought to be related to COVID-19. The mortality rate was 29.3%, and most deaths were considered related to cancer progression (27.8%).

Adverse events after vaccination included local pain and swelling, fever, headache, asthenia, general rash, regional lymph node enlargement, and arthromyalgia. Nearly all adverse events were grade 1 in nature, but 1 patient had grade 2 asthenia. 

Disclosures: This research was supported by Lilly. The presenter declared affiliations with Sanofi, Janssen, Bristol Myers Squibb, and Roche.

Reference

Hernandez A, Notario L, Quirant B, et al. Immune response after SARS-CoV-2 vaccination in lung cancer patients. Update of the Covid lung vaccine cohort. Presented at WCLC 2022. August 6-9, 2022. Presentation number OA06.04.