# Cell-based immune anticipation of the omicron variant in SARS-CoV-2 triple-vaccinated cancer patients

## TL;DR

Triple mRNA vaccination in cancer patients generates strong immune responses, including T cells that anticipate the Omicron variant, offering protection against severe disease.

## Contribution

The study reveals that T cell responses in vaccinated cancer patients anticipate Omicron mutations, indicating hybrid immunity and effective protection.

## Key findings

- 78% of actively treated cancer patients showed immune responses after a booster, compared to 50.8% before.
- T cell responses targeted both Omicron-mutated and non-mutated regions of the spike protein.
- Most cancer patients achieved high antibody levels after repeated vaccinations, preventing severe disease.

## Abstract

SARS-CoV-2 infections affect healthcare systems worldwide. Patients with cancer, a particularly vulnerable group, and oncology care takers were offered early access to mRNA-based vaccinations. We report the dynamics of humoral and cellular immune response parameters of 74 patients with cancer and 12 control participants after two basal vaccinations and a booster six months later. Upon booster vaccination, 78% of patients with tumor under active therapy (versus 50.8% prior to the boost) exhibited humoral and cellular spike protein responses, as compared to 100% and 73.3%, respectively, in those without active therapy. Conducted prior to the emergence of the Omicron variant of concern, we found Wuhan-Hu-1 spike-encoding mRNA vaccination to evoke T cell responses against peptides outside and within the Omicron-mutated region of the spike protein. The vast majority of patients with cancer achieved significant antibody titers upon repeated vaccinations. Accordingly, patients with tumor appeared well-protected, indicated by asymptomatic or mild breakthrough infections during the Omicron wave.

•Cellular and humoral immune response dynamics in vaccinated patients with cancer•Non-spike directed T cell responses as indicators of virus exposure/hybrid immunity•Preserved cellular reactivity in the anticipation of the Omicron variant•Effective protection of patients from severe COVID-19 by repeated mRNA vaccinations

Cellular and humoral immune response dynamics in vaccinated patients with cancer

Non-spike directed T cell responses as indicators of virus exposure/hybrid immunity

Preserved cellular reactivity in the anticipation of the Omicron variant

Effective protection of patients from severe COVID-19 by repeated mRNA vaccinations

Health sciences; Medicine; Medical specialty; Immunology; Oncology