Impact of Tyrosine Kinase Inhibitors on the Immune Response to SARS-CoV-2 Vaccination in Patients with Non-Small Cell Lung Cancer
Norma Hernández-Pedro,
Marisol Arroyo-Hernández,
Pedro Barrios-Bernal,
Eunice Romero-Nuñez,
Victor A. Sosa-Hernandez,
Santiago Ávila-Ríos,
José Luis Maravillas-Montero,
Rogelio Pérez-Padilla,
Diego de Miguel-Perez,
Christian Rolfo,
Oscar Arrieta
Affiliations
Norma Hernández-Pedro
Laboratorio de Medicina Personalizada, Instituto Nacional de Cancerología, S.S.A., San Fernando 22 Sección XVI, Tlalpan, Mexico City 14080, Mexico
Marisol Arroyo-Hernández
Thoracic Oncology Unit, Instituto Nacional de Cancerología, S.S.A., San Fernando 22 Sección XVI, Tlalpan, Mexico City 14080, Mexico
Pedro Barrios-Bernal
Laboratorio de Medicina Personalizada, Instituto Nacional de Cancerología, S.S.A., San Fernando 22 Sección XVI, Tlalpan, Mexico City 14080, Mexico
Eunice Romero-Nuñez
Laboratorio de Medicina Personalizada, Instituto Nacional de Cancerología, S.S.A., San Fernando 22 Sección XVI, Tlalpan, Mexico City 14080, Mexico
Victor A. Sosa-Hernandez
Red de Apoyo a la Investigación, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico
Santiago Ávila-Ríos
Centro de Investigación en Enfermedades Infecciosas (CIENI), Instituto Nacional de Enfermedades Respiratorias, Calzada de Tlalpan 4502, Belisario Domínguez Sección XVI, Tlalpan, Mexico City 14080, Mexico
José Luis Maravillas-Montero
Red de Apoyo a la Investigación, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico
Rogelio Pérez-Padilla
Department of Research on Tobacco and COPD, Instituto Nacional de Enfermedades Respiratorias, Calzada de Tlalpan 4502, Belisario Domínguez Sección XVI, Tlalpan, Mexico City 14080, Mexico
Diego de Miguel-Perez
Mount Sinai Health System, Icahn School of Medicine at Mount Sinai, New York, NY 11776, USA
Christian Rolfo
Mount Sinai Health System, Icahn School of Medicine at Mount Sinai, New York, NY 11776, USA
Oscar Arrieta
Thoracic Oncology Unit, Instituto Nacional de Cancerología, S.S.A., San Fernando 22 Sección XVI, Tlalpan, Mexico City 14080, Mexico
Immune dysregulation and cancer treatment may affect SARS-CoV-2 vaccination protection. Antibody production by B-cells play a vital role in the control and clearance of the SARS-CoV-2 virus. This study prospectively explores B-cell seroconversion following SARS-CoV-2 immunization in healthy individuals and non-small cell lung cancer (NSCLC) patients undergoing oncological treatment. 92 NSCLC patients and 27 healthy individuals’ blood samples were collected after receiving any COVID-19 vaccine. Serum and mononuclear cells were isolated, and a serum surrogate virus neutralization test kit evaluated SARS-CoV-2 antibodies. B-cell subpopulations on mononuclear cells were characterized by flow cytometry. Patients were compared based on vaccination specifications and target mutation oncological treatment. A higher percentage of healthy individuals developed more SARS-CoV-2 neutralizing antibodies than NSCLC patients (63% vs. 54.3%; p = 0.03). NSCLC patients receiving chemotherapy (CTX) or tyrosine kinase inhibitors (TKIs) developed antibodies in 45.2% and 53.7%, of cases, respectively, showing an impaired antibody generation. CTX patients exhibited trends towards lower median antibody production than TKIs (1.0, IQR 83 vs. 38.23, IQR 89.22; p = 0.069). Patients receiving immunotherapy did not generate antibodies. A sub-analysis revealed that those with ALK mutations exhibited non-significant trends towards higher antibody titers (63.02, IQR 76.58 vs. 21.78, IQR 93.5; p = 0.1742) and B-cells quantification (10.80, IQR 7.52 vs. 7.22, IQR 3.32; p = 0.1382) against the SARS-CoV-2 spike protein than EGFR patients; nonetheless, these differences were not statistically significant. This study shows that antibodies against SARS-CoV-2 may be impaired in patients with NSCLC secondary to EGFR-targeted TKIs compared to ALK-directed treatment.
