Center for Serological Testing to Improve Outcomes from Pandemic COVID-19 (STOP-COVID)

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Despite robust advances in vaccine technology and therapeutic intervention, the COVID-19 pandemic continues to impact our world both through disease-associated morbidity/mortality and its influence on economic stability and growth. Cancer patients (especially those receiving active immune suppressive or altering therapy) represent a highly vulnerable population with increased risk of SARS-CoV2 breakthrough infection and severe COVID-19 despite mRNA vaccination and booster. Identifying atrisk individuals and developing more effective protective strategies against severe COVID-19 is of paramount importance. We and others have characterized antibody and T cell responses in cancer patients and identified cancer treatment (type and timing) as critically associated with subpar vaccine responses. Notably, patients being treated for hematological malignancies have greater likelihood of impaired immunity compared with those with solid tumor malignancies. Furthermore, while booster immunization can recover deficiencies in immunity in some individuals, many cancer patients continue to have deficiencies in vaccine-mediated antibody and/or T cell responses. However, most post-booster studies have not assessed long-term durable immunity and have not characterized antibody or T cell memory responses. We hypothesize that variability in the durability and memory of T cell and antibody responses following booster immunization in solid tumor and hematological cancer patients will be primarily driven by type and timing of treatment. This hypothesis is supported by our publications assessing early post-booster immune responses, however, the research proposed here will allow us to T cell and antibody memory at 1 year post booster. Furthermore, by tracking clonal T cell populations and epitope specific antibody responses within individual cancer patients, we hypothesize that can identify key parameters driving heterogeneity in SARS-CoV2 mRNA booster responses. We will address our hypotheses via in-depth immunological studies using samples collected prospectively through the COVID-19 Vaccine Study of Infections and Immune REspoNse (SIIREN) at The Ohio State University Comprehensive Cancer Center.