Immunogenicity and safety of COVID-19 vaccines in patients with lung cancer : results of a systematic review and meta-analysis

ABSTRACT Introduction: COVID-19 has emerged as a significant worldwide health crisis in recent years, characterized by elevated morbidity and mortality rates. COVID-19 vaccinations can diminish transmission and safeguard people. The evaluation of immunogenicity and safety in high-risk populations, such as lung cancer patients, continues to provide a problem. This evaluation seeks to evaluate the safety and immunogenicity of COVID-19 vaccinations in patients with lung cancer. Methods: A search was conducted in PubMed, EMBASE, and Web of Science from January 2021 to November 2022 utilizing the keywords: COVID-19 OR SARS-CoV-2 AND COVID-19 vaccination AND lung cancer OR lung carcinoma. The subsequent requirements must be satisfied for inclusion: (1) Research involving at least 30 lung cancer patients undergoing active anti-tumor therapy alongside healthy controls; (2) COVID-19 vaccination; (3) Observational studies (either prospective or retrospective) and clinical trials featuring healthy controls; (4) The primary outcome measured was anti-SARS-CoV-2 spike IgG titers following the second dose of the COVID-19 vaccine in lung cancer patients. Secondary results included local and systemic adverse responses following the first and second doses. Antibody titers (mean ± standard deviation) were assessed for each study individually. The occurrence of adverse events following the first and second dosages was recorded Results: Eight studies were included, comprising 1,220 lung cancer patients and 599 healthy persons. IgG titers against the SARS-CoV-2 spike protein were markedly reduced in lung cancer patients compared to healthy controls, with a statistically significant difference (p=0.002). The safety profiles of lung cancer patients and healthy individuals were comparable: local reaction after the first vaccine: RR=0.90, 95% CI: 0.68-1.19; systemic reaction after the first vaccine: RR=0.92, 95% CI: 0.51-1.66; local reaction after the second vaccine: RR=0.81, 95% CI: 0.54-1.19; systemic reaction after the second vaccine: RR=1.20, 95% CI: 0.65-2.21. Conclusion: The antibody titer in lung cancer patients is markedly lower than that in the healthy group. Consequently, fatalities from COVID-19 may transpire in these people notwithstanding vaccination. Consequently, comprehensive protective measures must continue to be implemented to safeguard lung cancer patients who have received two doses of the COVID-19 vaccination against COVID-19.