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Assessment of Response to a Third Dose of the SARS-CoV-2 BNT162b2 mRNA Vaccine in Patients With Solid Tumors Undergoing Active Treatment

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

Following massive global initiatives, the US Food and Drug Administration approved several SARS-CoV-2 vaccines, including the BNT162b2 (Pfizer-BioNTech) mRNA vaccine. While manifestations of COVID-19 are heterogeneous, patients with solid tumors undergoing active therapy are at considerable risk for worse outcomes.1,2 Among these patients, humoral response to SARS-CoV-2 vaccines has been reported in approximately 90%.3 Although high, this proportion is considerably lower than the 99% to 100% found in control groups.4 Among patients who are treated with chemotherapy, further reduced humoral responses have been described.3

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Article Information

Accepted for Publication: October 15, 2021.

Published Online: November 23, 2021. doi:10.1001/jamaoncol.2021.6764

Corresponding Author: Albert Grinshpun, MD, MSc, Breast Oncology Center, Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA 02215 (albert_grinshpun@dfci.harvard.edu).

Author Contributions: Drs Rottenberg and Grinshpun had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Drs Rottenberg and Grinshpun served as co–first authors.

Concept and design: Grinshpun, Kadouri.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Rottenberg, Grinshpun, Oiknine Djian, Kadouri.

Critical revision of the manuscript for important intellectual content: Grinshpun, Ben-Dov, Wolf, Kadouri.

Statistical analysis: Ben-Dov.

Administrative, technical, or material support: Grinshpun, Oiknine Djian, Wolf, Kadouri.

Supervision: Rottenberg, Kadouri.

Conflict of Interest Disclosures: Dr Grinshpun reported support from the Israel Science Foundation (grant 3020/20) and the 2020 Conquer Cancer Israel Cancer Research Fund Career Development Award. Dr Kadouri reported support from Eli Lilly outside the submitted work. No other disclosures were reported.

Additional Contributions: We would like to thank all of the patients in this study as well as Miri Shapira from the Sharett Institute of Oncology at Hadassah Medical Center for her kind assistance in samples collection. Ms Shapira was compensated for her contributions.

References
1.
Brar  G , Pinheiro  LC , Shusterman  M ,  et al.  COVID-19 severity and outcomes in patients with cancer: a matched cohort study.   J Clin Oncol. 2020;38(33):3914-3924. doi:10.1200/JCO.20.01580PubMedGoogle ScholarCrossref
2.
Aschele  C , Negru  ME , Pastorino  A ,  et al.  Incidence of SARS-CoV-2 infection among patients undergoing active antitumor treatment in Italy.   JAMA Oncol. 2021;7(2):304-306. doi:10.1001/jamaoncol.2020.6778PubMedGoogle ScholarCrossref
3.
Grinshpun  A , Rottenberg  Y , Ben-Dov  IZ , Djian  E , Wolf  DG , Kadouri  L .  Serologic response to COVID-19 infection and/or vaccine in cancer patients on active treatment.   ESMO Open. 2021;6(6):100283. doi:10.1016/j.esmoop.2021.100283PubMedGoogle Scholar
4.
Herishanu  Y , Avivi  I , Aharon  A ,  et al.  Efficacy of the BNT162b2 mRNA COVID-19 vaccine in patients with chronic lymphocytic leukemia.   Blood. 2021;137(23):3165-3173. doi:10.1182/blood.2021011568PubMedGoogle ScholarCrossref
5.
Bar-On  YM , Goldberg  Y , Mandel  M ,  et al.  Protection of BNT162b2 vaccine booster against Covid-19 in Israel.   N Engl J Med. 2021;385(15):1393-1400. doi:10.1056/NEJMoa2114255PubMedGoogle ScholarCrossref
6.
Kamar  N , Abravanel  F , Marion  O , Couat  C , Izopet  J , Del Bello  A .  Three doses of an mRNA Covid-19 vaccine in solid-organ transplant recipients.   N Engl J Med. 2021;385(7):661-662. doi:10.1056/NEJMc2108861PubMedGoogle ScholarCrossref
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