March 22, 2021 (BRONX, NY)-- Most people with cancer who are infected by the novel coronavirus produce antibodies at a rate comparable to the rest of the population--but their ability to do so depends on their type of cancer and the treatments they've received, according to a new study by researchers at Montefiore Health System and Albert Einstein College of Medicine. The findings, published online today in Nature Cancer, may lead to better care for cancer patients, who face a heightened risk of dying from COVID-19, and suggests that cancer patients should respond well to COVID-19 vaccines.
"We conducted the study out of our concern that cancer patients who develop COVID-19 may not benefit from the same degree of antibody protection as people without cancer, given that many are immuno-compromised," said Astha Thakkar, M.B.B.S., a Montefiore hematologic oncology fellow and first author of the paper. "Our findings provide assurance that most people with cancer are able to mount an antibody response to the coronavirus that is similar to the general population. People with a history of cancer are likely as protected from reinfection as those without a history of disease and are likely to respond well to vaccines, according to our study."
The retrospective study involved 261 cancer patients, 77% of whom were diagnosed with solid malignancies and 23% with hematologic (blood) malignancies. Their overall rate of seroconversion (production of antibodies in response to infection) was 92%. However, when patients with solid and blood malignancies were compared, patients with blood cancers had a seroconversion rate of only 81.7%--significantly lower than the 94.5% seroconversion rate for patients with solid tumors.
"The treatments commonly given to patients with blood cancers--anti-CD20 antibody therapy, stem-cell transplants, and steroids--are known to suppress the immune system, which may explain the lower rate of antibodies developed in these patients and their increased risk for severe COVID-19 disease," said senior author Balazs Halmos, M.D., M.S., director of the Multidisciplinary Thoracic Oncology Program at Montefiore, professor of medicine at Einstein, and a member of the Albert Einstein Cancer Center (AECC).
"We need to pay special attention to patients with blood cancers and think through proactive strategies to ensure this patient population is appropriately cared for," said Sanjay Goel, M.B.B.S., a medical oncologist at Montefiore, professor of medicine at Einstein, a member of AECC, and a coauthor on the paper. "This study also raises the need for additional research on COVID-19 vaccines and current treatments for people with blood cancer."
In a paper published last year in Cancer Discovery, Dr. Halmos and colleagues found that COVID-19 patients with blood cancers had significantly higher mortality rates compared with patients who had solid tumors. Mortality was more closely related to age and co-morbidities than active cancer therapy.
The study participants were cared for at Montefiore between March 1, 2020 and September 15, 2020 and tested positive for COVID-19 through PCR tests to detect coronavirus or prior COVID-19 exposure through antibody testing, or both. The patients had an average age of 64 and were almost evenly split between men and women. Fifty-six percent of patients (147/261) had symptomatic coronavirus infection, while 44% (114/261) had an asymptomatic infection.
More than 40% of patients were African American; 30% were Hispanic, nearly 15% were Caucasian, 3% were Asian, and 6% belong to other ethnic groups.
The paper is titled "Patterns of seroconversion for SARS-COV2-IgG in Patients with Malignant Disease and association with anti-cancer therapy."
Additional Montefiore-Einstein authors are: Kith Pradhan, Ph.D., Shawn Jindal, M.D., Zhu Cui, M.D., M.P.H., Bradley Rockwell, M.D., Akash Pradip Shah, M.S., Stuart Packer, M.D., R. Alejandro Sica, M.D., Joseph A Sparano, M.D., D. Yitzhak Goldstein, M.D., and Amit Verma, M.B.B.S.
This study was supported in part by the Albert Einstein Cancer Center (P30 CA013330 and NCORP grant 2UG1CA189859-06) and by the Jane A. and Myles P. Dempsey fund and the Pelka family fund. The authors declare no conflicts of interest.
About Montefiore Health System
Montefiore Health System is one of New York's premier academic health systems and is a recognized leader in providing exceptional quality and personalized, accountable care to approximately three million people in communities across the Bronx, Westchester and the Hudson Valley. It is comprised of 11 hospitals, including the Children's Hospital at Montefiore, Burke Rehabilitation Hospital and close to 200 outpatient care sites. The advanced clinical and translational research at its medical school, Albert Einstein College of Medicine, directly informs patient care and improves outcomes. From the Montefiore-Einstein Centers of Excellence in cancer, cardiology and vascular care, pediatrics, and transplantation, to its preeminent school-based health program, Montefiore is a fully integrated healthcare delivery system providing coordinated, comprehensive care to patients and their families. For more information please visit http://www.montefiore.org. Follow us on Twitter) and view us on Facebook and YouTube.
About Albert Einstein College of Medicine
Albert Einstein College of Medicine is one of the nation's premier centers for research, medical education and clinical investigation. During the 2020-21 academic year, Einstein is home to 721 M.D. students, 178 Ph.D. students, 109 students in the combined M.D./Ph.D. program, and 265 postdoctoral research fellows. The College of Medicine has more than 1,900 full-time faculty members located on the main campus and at its clinical affiliates. In 2020, Einstein received more than $197 million in awards from the National Institutes of Health (NIH). This includes the funding of major research centers at Einstein in aging, intellectual development disorders, diabetes, cancer, clinical and translational research, liver disease, and AIDS. Other areas where the College of Medicine is concentrating its efforts include developmental brain research, neuroscience, cardiac disease, and initiatives to reduce and eliminate ethnic and racial health disparities. Its partnership with Montefiore, the University Hospital and academic medical center for Einstein, advances clinical and translational research to accelerate the pace at which new discoveries become the treatments and therapies that benefit patients. Einstein runs one of the largest residency and fellowship training programs in the medical and dental professions in the United States through Montefiore and an affiliation network involving hospitals and medical centers in the Bronx, Brooklyn and on Long Island. For more information, please visit einsteinmed.org, read our blog, follow us on Twitter, like us on Facebook, and view us on YouTube.