New research confirmed the safety of mRNA COVID-19 vaccines in individuals with cancer who are undergoing immunotherapy, according to a novel study published by Widman et al in JNCCN–Journal of the National Comprehensive Cancer Network.
The researchers analyzed the frequency of immune-related adverse events in 408 patients receiving immune checkpoint inhibitor therapy between January 16, 2021, and March 27, 2021. They found no increase in the type, frequency, or severity of side effects from those receiving both immunotherapy and the vaccine at the same time.
“We see no evidence to suggest that taking the [mRNA] COVID-19 vaccine increases the risk of immune-related adverse events in newly or previously immune checkpoint inhibitor–treated patients. Also, the vaccine will not disrupt treatment or lead to early discontinuation,” said senior study author Mini Kamboj, MD, Chief Medical Epidemiologist of Infection Control at Memorial Sloan Kettering Cancer Center. “Vaccines continue to offer strong protection from severe COVID-19 [infection] for all variants, and patients are highly encouraged to stay up-to-date on their COVID-19 vaccination.”
The study’s findings supported recommendations by the National Comprehensive Cancer Network (NCCN) for COVID-19 vaccination in individuals with cancer. The current guidance acknowledges that there is an acceptable safety profile for COVID-19 vaccination in patients being treated with immunotherapy, while also calling for more data—uncertainties that the novel research hoped to dispel.
“The main catalyst for this study was vaccine hesitancy among patients [receiving] immunotherapy and the uncertainty among treating clinicians on how to address these concerns,” explained lead study author Adam Widman, MD, an oncologist at Memorial Sloan Kettering Cancer Center, citing a previous study published by Waissengrin et al in The Lancet Oncology that found that approximately one-fifth of patients receiving immune checkpoint inhibitors were reluctant to get vaccinated against COVID-19 infection because of the fear of added side effects. “This was surprising, since there is overwhelming evidence of higher risk for COVID-19 infection–related complications in patients actively receiving cancer treatment. We felt it was essential to share our experience and encourage vaccine uptake in this vulnerable population.”
“It is encouraging that patients treated with immunotherapy who were also vaccinated for COVID-19 did not experience immune checkpoint toxicity at a greater rate than those patients who received immunotherapy and were unvaccinated,” commented Bryan J. Schneider, MD, a Clinical Professor of Medical Oncology and Internal Medicine at the University of Michigan Rogel Cancer Center, and the Vice Chair of the NCCN Clinical Practice Guidelines in Oncology Panel for Management of Immunotherapy-Related Toxicities, who was not involved in the research. “The worry that side effects would increase during immune checkpoint therapy may have led patients or providers away from routine vaccination; however, recent reviews have not supported this concern. Patients should receive mRNA-based vaccines per institutional guidelines.”
The researchers stressed that the findings should encourage new and third-dose vaccine uptake among patients with cancer who are receiving immune checkpoint inhibitors, without interruption of cancer therapy.
Disclosure: For full disclosures of the study authors, visit jnccn.org.
