{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T00:58:32Z","timestamp":1760057912831,"version":"build-2065373602"},"reference-count":46,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T00:00:00Z","timestamp":1741132800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"AIOM (Associazione Italiana di Oncologia Medica)"},{"name":"FICOG (Federation of Italian Cooperative Oncology Groups)"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Background: As COVID-19 has become an epidemic, we conducted an open-label study aimed to identify immunogenicity and reactogenicity of boosters of the BNT162b2 vaccine in a real-world cohort of long-survivor metastatic lung cancer patients (LS-mLC pts). Methods and Analysis: According to the timing of the booster dose (BD) and SARS-CoV-2 infection (Cov-I) during anticancer treatment (ACT), between October 2021 and February 2022, we prospectively enrolled 166 cancer patients into five parallel cohorts. The primary endpoints were seroprevalence of IgG Anti-spike-RBD (anti-S IgG) at two pre-defined timepoints (T1: +30\u201390 days after BD; T2: +6 months +\/\u2212 4 weeks after BD). As an exploratory endpoint, we compared the median pre-vaccination value of four cytokines (IL-6, IL-2R, TNF-\u03b1, IL-10) with post-BD values in immunotherapy-treated pts (IO-pts). Results: The anti-S IgG seropositivity rate was 100% at T1 and 98.8% at T2. After 6 months, hybrid immunisation was associated with a higher median anti-S IgG titre compared to vaccine-alone-induced seroconversion (p &lt; 0.0001). In uninfected pts, the median anti-S IgG titre was significantly lower in IO-pts compared to non-IO-pts (p = 0.02); no difference was found when comparing myelosuppressive or not ACT. Among the 68 IO-pts, 5 pts (7.3%) showed a significant increase (\u22651.5 fold) of at least two cytokines in post-BD samples, without reporting ir-AEs. Conclusions: Boosters of the COVID-19 mRNA vaccine were effective and safe. In IO-pts without recent Cov-I, additional BDs should be considered to prolong serological immunity.<\/jats:p>","DOI":"10.3390\/vaccines13030273","type":"journal-article","created":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T05:54:38Z","timestamp":1741154078000},"page":"273","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["COVALENCE STUDY: Immunogenicity and Reactogenicity of a COVID-19 mRNA Vaccine in an Open-Label Cohort of Long-Survivor Patients with Metastatic Lung Cancer"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4546-547X","authenticated-orcid":false,"given":"Emanuele","family":"Vita","sequence":"first","affiliation":[{"name":"UOSD Oncologia Toraco-Polmonare, Comprehensive Cancer Center, Fondazione Policlinico Universitario A. Gemelli IRCCS, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federico","family":"Monaca","sequence":"additional","affiliation":[{"name":"UOC Oncologia Medica, Comprehensive Cancer Center, Fondazione Policlinico Universitario A. Gemelli IRCCS, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1853-4927","authenticated-orcid":false,"given":"Luca","family":"Mastrantoni","sequence":"additional","affiliation":[{"name":"UOC Oncologia Medica, Comprehensive Cancer Center, Fondazione Policlinico Universitario A. Gemelli IRCCS, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geny","family":"Piro","sequence":"additional","affiliation":[{"name":"UOC Oncologia Medica, Comprehensive Cancer Center, Fondazione Policlinico Universitario A. Gemelli IRCCS, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1133-6303","authenticated-orcid":false,"given":"Giacomo","family":"Moretti","sequence":"additional","affiliation":[{"name":"UOC Chimica, Biochimica e Biologia Molecolare Clinica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ileana","family":"Sparagna","sequence":"additional","affiliation":[{"name":"UOC Oncologia Medica, Comprehensive Cancer Center, Fondazione Policlinico Universitario A. Gemelli IRCCS, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5816-4484","authenticated-orcid":false,"given":"Alessio","family":"Stefani","sequence":"additional","affiliation":[{"name":"UOC Oncologia Medica, Comprehensive Cancer Center, Fondazione Policlinico Universitario A. Gemelli IRCCS, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1582-8006","authenticated-orcid":false,"given":"Antonio","family":"Vitale","sequence":"additional","affiliation":[{"name":"UOC Oncologia Medica, Comprehensive Cancer Center, Fondazione Policlinico Universitario A. Gemelli IRCCS, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Trovato","sequence":"additional","affiliation":[{"name":"UOC Oncologia Medica, Comprehensive Cancer Center, Fondazione Policlinico Universitario A. Gemelli IRCCS, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3796-3877","authenticated-orcid":false,"given":"Mariantonietta","family":"Di Salvatore","sequence":"additional","affiliation":[{"name":"UOSD Oncologia Toraco-Polmonare, Comprehensive Cancer Center, Fondazione Policlinico Universitario A. Gemelli IRCCS, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9780-7059","authenticated-orcid":false,"given":"Maurizio","family":"Sanguinetti","sequence":"additional","affiliation":[{"name":"UOC Microbiologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Urbani","sequence":"additional","affiliation":[{"name":"UOC Chimica, Biochimica e Biologia Molecolare Clinica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca","family":"Richeldi","sequence":"additional","affiliation":[{"name":"UOC Pneumologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmine","family":"Carbone","sequence":"additional","affiliation":[{"name":"UOC Oncologia Medica, Comprehensive Cancer Center, Fondazione Policlinico Universitario A. Gemelli IRCCS, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2333-704X","authenticated-orcid":false,"given":"Emilio","family":"Bria","sequence":"additional","affiliation":[{"name":"UOSD Oncologia Toraco-Polmonare, Comprehensive Cancer Center, Fondazione Policlinico Universitario A. Gemelli IRCCS, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giampaolo","family":"Tortora","sequence":"additional","affiliation":[{"name":"UOC Oncologia Medica, Comprehensive Cancer Center, Fondazione Policlinico Universitario A. Gemelli IRCCS, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"914","DOI":"10.1016\/S1470-2045(20)30314-4","article-title":"COVID-19 in patients with thoracic malignancies (TERAVOLT): First results of an international, registry-based, cohort study","volume":"21","author":"Garassino","year":"2020","journal-title":"Lancet Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1386","DOI":"10.1016\/j.annonc.2020.06.007","article-title":"COVID-19 in patients with lung cancer","volume":"31","author":"Luo","year":"2020","journal-title":"Ann. 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Lung Cancer"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1016\/j.jtho.2021.10.015","article-title":"Efficacy of Severe Acute Respiratory Syndrome Coronavirus-2 Vaccine in Patients with Thoracic Cancer: A Prospective Study Supporting a Third Dose in Patients with Minimal Serologic Response after Two Vaccine Doses","volume":"17","author":"Gounant","year":"2022","journal-title":"J. Thorac. Oncol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1002","DOI":"10.1016\/j.jtho.2022.05.015","article-title":"Safety and Immunogenicity of mRNA Vaccines against Severe Acute Respiratory Syndrome Coronavirus 2 in Patients with Lung Cancer Receiving Immune Checkpoint Inhibitors: A Multicenter Observational Study in Japan","volume":"17","author":"Hibino","year":"2022","journal-title":"J. Thorac. Oncol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2140549","DOI":"10.1080\/21645515.2022.2140549","article-title":"Immunogenicity and safety of COVID-19 vaccine in lung cancer patients receiving anticancer treatment: A prospective multicenter cohort study","volume":"18","author":"Nakashima","year":"2022","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Hernandez, A., Boigues, M., Felip, E., Cucurull, M., Notario, L., Pous, A., Torres, P., Benitez, M., Rodriguez, M., and Quirant, B. (2023). Immune Response and Effects of COVID-19 Vaccination in Patients with Lung Cancer\u2014COVID Lung Vaccine Study. Cancers, 15.","DOI":"10.3390\/cancers15010137"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"3808","DOI":"10.1200\/JCO.21.02986","article-title":"Antibody Response to COVID-19 mRNA Vaccine in Patients With Lung Cancer After Primary Immunization and Booster: Reactivity to the SARS-CoV-2 WT Virus and Omicron Variant","volume":"40","author":"Valanparambil","year":"2022","journal-title":"J. Clin. Oncol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1016\/j.ccell.2022.04.012","article-title":"Longitudinal COVID-19-vaccination-induced antibody responses and Omicron neutralization in patients with lung cancer","volume":"40","author":"Mack","year":"2022","journal-title":"Cancer Cell"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e83694","DOI":"10.7554\/eLife.83694","article-title":"Study of efficacy and longevity of immune response to third and fourth doses of COVID-19 vaccines in patients with cancer: A single arm clinical trial","volume":"12","author":"Thakkar","year":"2023","journal-title":"eLife"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1016\/j.ejca.2021.08.007","article-title":"Efficacy and safety of BNT162b2 vaccination in patients with solid cancer receiving anticancer therapy\u2014A single centre prospective study","volume":"157","author":"Shmueli","year":"2021","journal-title":"Eur. J. Cancer"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1716","DOI":"10.1001\/jamaoncol.2021.2155","article-title":"Durability of Response to SARS-CoV-2 BNT162b2 Vaccination in Patients on Active Anticancer Treatment","volume":"7","author":"Massarweh","year":"2021","journal-title":"JAMA Oncol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1001\/jamaoncol.2021.5437","article-title":"Humoral immune response in hematooncological patients and health care workers who received SARS-CoV-2 vaccinations","volume":"8","author":"Mair","year":"2022","journal-title":"JAMA Oncol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"3674","DOI":"10.1182\/blood.2021011904","article-title":"Low neutralizing antibody responses against SARS-CoV-2 in older patients with myeloma after the first BNT162b2 vaccine dose","volume":"137","author":"Terpos","year":"2021","journal-title":"Blood"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1016\/S1470-2045(21)00155-8","article-title":"Short-term safety of the BNT162b2 mRNA COVID-19 vaccine in patients with cancer treated with immune checkpoint inhibitors","volume":"22","author":"Waissengrin","year":"2021","journal-title":"Lancet Oncol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1038\/s41419-022-05548-4","article-title":"Longitudinal efficacy and toxicity of SARS-CoV-2 vaccination in cancer patients treated with immunotherapy","volume":"14","author":"Spiliopoulou","year":"2023","journal-title":"Cell Death Dis."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"100272","DOI":"10.1016\/j.esmoop.2021.100272","article-title":"A snapshot of the immunogenicity, efficacy and safety of a full course of BNT162b2 anti-SARS-CoV-2 vaccine in cancer patients treated with PD-1\/PD-L1 inhibitors: A longitudinal cohort study","volume":"6","author":"Lasagna","year":"2021","journal-title":"ESMO Open"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"100359","DOI":"10.1016\/j.esmoop.2021.100359","article-title":"Analysis of the humoral and cellular immune response after a full course of BNT162b2 anti-SARS-CoV-2 vaccine in cancer patients treated with PD-1\/PD-L1 inhibitors with or without chemotherapy: An update after 6 months of follow-up","volume":"7","author":"Lasagna","year":"2022","journal-title":"ESMO Open"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1038\/s43018-022-00398-7","article-title":"Cytokine release syndrome-like serum responses after COVID-19 vaccination are frequent and clinically inapparent under cancer immunotherapy","volume":"3","author":"Walle","year":"2022","journal-title":"Nat. Cancer"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"91","DOI":"10.2217\/imt-2021-0235","article-title":"The mRNA COVID-19 vaccine in patients with cancer receiving checkpoint inhibitor therapy: What we know and what we don\u2019t","volume":"14","author":"Malek","year":"2022","journal-title":"Immunotherapy"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1038\/s41586-020-2814-7","article-title":"COVID-19 vaccine BNT162b1 elicits human antibody and TH1 T cell responses","volume":"586","author":"Sahin","year":"2020","journal-title":"Nature"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"878","DOI":"10.1038\/s41423-020-0484-x","article-title":"Potential contribution of increased soluble IL-2R to lymphopenia in COVID-19 patients","volume":"17","author":"Zhang","year":"2020","journal-title":"Cell. Mol. Immunol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1038\/s41392-020-0148-4","article-title":"Lymphopenia predicts disease severity of COVID-19: A descriptive and predictive study","volume":"5","author":"Tan","year":"2020","journal-title":"Signal Transduct. Target. Ther."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2144","DOI":"10.1158\/1078-0432.CCR-18-1449","article-title":"The First-week Proliferative Response of Peripheral Blood PD-1+CD8+ T Cells Predicts the Response to Anti-PD-1 Therapy in Solid Tumors","volume":"25","author":"Kim","year":"2019","journal-title":"Clin. Cancer Res."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.lungcan.2020.07.028","article-title":"Soluble PD-L1 and Circulating CD8+PD-1+ and NK Cells Enclose a Prognostic and Predictive Immune Effector Score in Immunotherapy Treated NSCLC patients","volume":"148","author":"Mazzaschi","year":"2020","journal-title":"Lung Cancer"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"e196879","DOI":"10.1001\/jamanetworkopen.2019.6879","article-title":"Association of Survival and Immune-Related Biomarkers With Immunotherapy in Patients With Non-Small Cell Lung Cancer: A Meta-analysis and Individual Patient-Level Analysis","volume":"2","author":"Yu","year":"2019","journal-title":"JAMA Netw. Open"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.1038\/s43018-021-00275-9","article-title":"Adaptive immunity and neutralizing antibodies against SARS-CoV-2 variants of concern following vaccination in patients with cancer: The CAPTURE study","volume":"2","author":"Fendler","year":"2021","journal-title":"Nat. Cancer"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"2603","DOI":"10.1056\/NEJMoa2034577","article-title":"Safety and efficacy of the BNT162b2 mRNA Covid-19 Vaccine","volume":"383","author":"Polack","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1761","DOI":"10.1056\/NEJMoa2110345","article-title":"Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine through 6 Months","volume":"385","author":"Thomas","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"e84","DOI":"10.1056\/NEJMoa2114583","article-title":"Waning Immune Humoral Response to BNT162b2 COVID-19 Vaccine over 6 Months","volume":"385","author":"Levin","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e2310650","DOI":"10.1001\/jamanetworkopen.2023.10650","article-title":"Evaluation of Waning of SARS-CoV-2 Vaccine-Induced Immunity: A Systematic Review and Meta-analysis","volume":"6","author":"Menegale","year":"2023","journal-title":"JAMA Netw. Open"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1016\/j.annonc.2021.12.006","article-title":"COVID-19 vaccination and breakthrough infections in patients with cancer","volume":"33","author":"Schmidt","year":"2022","journal-title":"Ann. Oncol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1001\/jamaoncol.2022.6815","article-title":"Association of COVID-19 Vaccination with Breakthrough Infections and Complications in Patients with Cancer","volume":"9","author":"Gong","year":"2023","journal-title":"JAMA Oncol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1414","DOI":"10.1200\/JCO.21.02419","article-title":"Risk and Outcome of Breakthrough COVID-19 Infections in Vaccinated Patients with Cancer: Real-World Evidence from the National COVID Cohort Collaborative","volume":"40","author":"Song","year":"2022","journal-title":"J. Clin. Oncol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1038\/s41392-022-00950-y","article-title":"Advances in COVID-19 mRNA vaccine development","volume":"7","author":"Fang","year":"2022","journal-title":"Signal Transduct. Target. Ther."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Bettini, E., and Locci, M. (2021). SARS-CoV-2 mRNA Vaccines: Immunological Mechanism and Beyond. Vaccines, 9.","DOI":"10.3390\/vaccines9020147"}],"container-title":["Vaccines"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-393X\/13\/3\/273\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:47:31Z","timestamp":1760028451000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-393X\/13\/3\/273"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,5]]},"references-count":46,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["vaccines13030273"],"URL":"https:\/\/doi.org\/10.3390\/vaccines13030273","relation":{},"ISSN":["2076-393X"],"issn-type":[{"type":"electronic","value":"2076-393X"}],"subject":[],"published":{"date-parts":[[2025,3,5]]}}}