Adaptive immunity and neutralizing antibodies against SARS-CoV-2 variants of concern following vaccination in patients with cancer: the CAPTURE study

Nat Cancer. 2021 Dec;2(12):1305-1320. doi: 10.1038/s43018-021-00274-w. Epub 2021 Oct 27.


Coronavirus disease 2019 (COVID-19) antiviral response in a pan-tumor immune monitoring (CAPTURE) ( NCT03226886 ) is a prospective cohort study of COVID-19 immunity in patients with cancer. Here we evaluated 585 patients following administration of two doses of BNT162b2 or AZD1222 vaccines, administered 12 weeks apart. Seroconversion rates after two doses were 85% and 59% in patients with solid and hematological malignancies, respectively. A lower proportion of patients had detectable titers of neutralizing antibodies (NAbT) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern (VOC) versus wild-type (WT) SARS-CoV-2. Patients with hematological malignancies were more likely to have undetectable NAbT and had lower median NAbT than those with solid cancers against both SARS-CoV-2 WT and VOC. By comparison with individuals without cancer, patients with hematological, but not solid, malignancies had reduced neutralizing antibody (NAb) responses. Seroconversion showed poor concordance with NAbT against VOC. Previous SARS-CoV-2 infection boosted the NAb response including against VOC, and anti-CD20 treatment was associated with undetectable NAbT. Vaccine-induced T cell responses were detected in 80% of patients and were comparable between vaccines or cancer types. Our results have implications for the management of patients with cancer during the ongoing COVID-19 pandemic.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Antibodies, Neutralizing / blood
  • Antibodies, Neutralizing / immunology
  • Antibodies, Viral / blood
  • Antibodies, Viral / immunology
  • BNT162 Vaccine / administration & dosage
  • BNT162 Vaccine / immunology*
  • COVID-19 / blood
  • COVID-19 / immunology
  • COVID-19 / prevention & control*
  • ChAdOx1 nCoV-19 / administration & dosage
  • ChAdOx1 nCoV-19 / immunology*
  • Female
  • Humans
  • Immunity, Cellular
  • Immunogenicity, Vaccine
  • Male
  • Middle Aged
  • Neoplasms / blood
  • Neoplasms / complications
  • Neoplasms / immunology*
  • Prospective Studies
  • SARS-CoV-2 / immunology*
  • T-Lymphocytes / immunology


  • Antibodies, Neutralizing
  • Antibodies, Viral
  • ChAdOx1 nCoV-19
  • BNT162 Vaccine

Supplementary concepts

  • SARS-CoV-2 variants

Associated data