Owing to high COVID-19-related morbidity and fatality rate among patients with cancer, the introduction of COVID-19 vaccines is of profound significance in this fragile population. Accumulated data suggested that oncologic patients, especially those with anti-cancer therapy have an impaired immune response to COVID-19 vaccination. However, the exact effect of anti-cancer treatments on post-vaccination response has not been elucidated yet. We therefore conducted a meta-analysis to evaluate the impact of treatments on response to COVID-19 vaccination in patients with cancer. A total of 39 studies were finally included comprising 11075 oncologic patients. Overall, we found humoral response was significantly decreased in patients undergoing anti-cancer treatments (OR=2.55, 95% CI: 2.04-3.18) compared with those without active treatment. The seroconversion rates were significantly lower in patients with chemotherapy (OR=3.04, 95% CI: 2.28-4.05), targeted therapy (OR=4.72, 95% CI: 3.18-7.01) and steroid usage (OR=2.19, 95% CI: 1.57-3.07), while there was no significant association between immunotherapy or hormonal therapy and seroconversion after vaccination. Subgroup analyses showed therapies with anti-CD20 antibody (OR=11.28, 95% CI: 6.40-19.90), BCL2i (OR=5.76, 95% CI: 3.64-9.10) and BTKi (OR=6.86, 95% CI: 4.23-11.15) were significantly correlated with the risk of negative humoral response to vaccination. In conclusion, our results demonstrated that specific oncologic therapies may significantly affect serological response to COVID-19 vaccines in patients with cancer. Thus, an adapted vaccination strategy taking the influence of active treatment into account is in need, and further research on the effect of a third dose of vaccine and the role of post-vaccination cellular response in oncologic patients is also needed. This article is protected by copyright. All rights reserved.
- Older adults
- Vaccine/vaccination
- COVID-19
- Efficacy/effectiveness
