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David S. Ettinger, MD, FACP, FCCP


COVID-19 Vaccination in Immune Checkpoint Inhibitor–Treated Patients With Lung Cancer in Japan

By: Julia Fiederlein
Posted: Monday, August 8, 2022

In response to the COVID-19 pandemic, patients with cancer have been prioritized for vaccination; thus, Makoto Hibino, MD, of the Shonan Fujisawa Tokushukai Hospital, Fujisawa, Japan, and colleagues conducted a study to evaluate and validate the safety and immunogenicity of these mRNA-based vaccines in those with lung cancer who were actively undergoing immune checkpoint inhibition. The results of this multicenter observational study, which were published in the Journal of Thoracic Oncology, shed light on the real-world risk of vaccine-associated immune-related adverse events in this population.

“Patients with lung cancer who were actively treated with immune checkpoint inhibitors were safely vaccinated without an increased incidence of immune-related adverse events in a real-world setting; however, their immune response to vaccination was lower and might be less effective in preventing COVID-19,” the investigators commented. “In the future, real-world vaccination efficacy in patients with lung cancer who are actively being treated with immune checkpoint inhibitors should be evaluated, as they are a particularly vulnerable patient group.”

The investigators focused on 126 Japanese patients who received anti–PD-1 (nivolumab or pembrolizumab) or anti–PD-L1 (durvalumab or atezolizumab) antibodies at least once between the 4 weeks before the first dose of the SARS–CoV-2 vaccine and the 4 weeks after the second dose. Immunogenicity was assessed by measuring anti–spike (S)-immunoglobulin G (IgG) antibody levels.

Immune-related adverse events of any grade were reported in 20.6% and 5.6% of patients before and after vaccination, respectively; according to the investigators, these rates were lower than the predicted incidence without vaccination (35.0%). After vaccination, no patients exhibited an exacerbation of a preexisting immune-related adverse event. The S-IgG antibody seroconversion rate was 96.7% in patients with lung cancer and 100% in an age- and sex-matched control population; however, the antibody levels seemed to be significantly lower in those with lung cancer (P < .001).

Disclosure: The study authors reported no conflicts of interest.

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