Patients with cancer have received priority status to receive COVID-19 vaccinations, but limited data are available regarding the safety and efficacy of the vaccines for patients treated with immune checkpoint inhibitors for lung cancer. Now, a new study published by Hibino et al in the Journal of Thoracic Oncology has found that vaccines are safe and effective for these patients.
Patients with cancer are at an increased risk for SARS–CoV-2 infection and severe COVID-19 because of the lowered immunity associated with anticancer drugs, radiation therapy, and cancer itself, as well as increased exposure to the virus due to frequent visits to the clinic or the hospital. Also, patients with cancer are often elderly, and old age itself leads to declined immunocompetence. Currently, immune checkpoint inhibitors such as anti–PD-1, anti–PD-L1, and anti–CTLA-4 antibodies are widely used as single agents or in combination with other anticancer agents and radiation therapy for the treatment of various carcinomas, including lung cancer.
Study Details
Japanese researchers led by Makoto Hibino, MD, of Shonan Fujisawa Tokushukai Hospital in Fujisawa, Japan, enrolled 126 patients with lung cancer who were actively treated with immune checkpoint inhibitors from 4 weeks before their first vaccination to 4 weeks after their second vaccination. Researchers sought to learn whether the incidence of immune-related adverse events in these patients receiving the vaccines was less than 35%, a standard set by previous studies.
The median age of the enrolled patients was 71 years. Patients were followed from May 2021 until December 2021.
Of the 126 patients enrolled, 26 (20.6%, 95% confidence interval [CI] = 13.9%–28.8%) developed immune-related adverse events of any grade prevaccination, and 7 (5.6%, 95% CI = 2.3%–11.1%) developed immune-related adverse events of any grade postvaccination, which was lower than the predicted incidence without vaccination. None of the patients experienced exacerbation of preexisting immune-related adverse events postvaccination, and S-IgG antibodies were seroconverted in 96.7% and 100% of the patients with lung cancer and controls, respectively, but antibody levels were significantly lower in patients with lung cancer (P < .001). The percentage of patients who developed any grade of new-onset immune-related adverse events was not higher than the expected value of 35% inferred from previously published literature, according to Dr. Hibino.
“Patients with lung cancer who were actively treated with immune checkpoint inhibitors were safely vaccinated without an increased incidence of immune-related adverse events; however, their vaccine immunogenicity was lower, and this requires further evaluation,” concluded Dr. Hibino.
Disclosure: For full disclosures of the study authors, visit jto.org.
