Impact of COVID-19 vaccination on the use of PD-1 inhibitor in treating patients with cancer: a real-world study

Anti-COVID-19 vaccination may have functional implications for immune checkpoint inhibitor treatment in patients with cancer. This study was undertaken to determine whether the safety or efficacy of anti-PD-1 therapy is reduced in patients with cancer during COVID-19 vaccination. A large multicenter...

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Main Authors: Yang Yang, Junping Yin, Jian Li, Bo Liu, Ming Li, Qiao Huang, Xianglin Yuan, Christian Kurts, Guangyuan Hu, Qi Mei, Xi Tang, Alexander Böhner, Amy Bryant
Format: Article
Language:English
Published: BMJ Publishing Group 2022-03-01
Series:Journal for ImmunoTherapy of Cancer
Online Access:https://jitc.bmj.com/content/10/3/e004157.full
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author Yang Yang
Junping Yin
Jian Li
Bo Liu
Ming Li
Qiao Huang
Xianglin Yuan
Christian Kurts
Guangyuan Hu
Qi Mei
Xi Tang
Alexander Böhner
Amy Bryant
author_facet Yang Yang
Junping Yin
Jian Li
Bo Liu
Ming Li
Qiao Huang
Xianglin Yuan
Christian Kurts
Guangyuan Hu
Qi Mei
Xi Tang
Alexander Böhner
Amy Bryant
author_sort Yang Yang
collection DOAJ
description Anti-COVID-19 vaccination may have functional implications for immune checkpoint inhibitor treatment in patients with cancer. This study was undertaken to determine whether the safety or efficacy of anti-PD-1 therapy is reduced in patients with cancer during COVID-19 vaccination. A large multicenter observational study was conducted in 83 Chinese hospitals between January 28, 2021 and September 30, 2021. A total of 3552 patients were screened and 2048 eligible patients with cancer receiving PD-1 inhibitor treatment were recruited. All enrolled patients had received camrelizumab treatment alone or in conjunction with other cancer therapies. Among these, 1518 (74.1%) patients received the BBIBP-CorV vaccine and were defined as the vaccinated subgroup. The remaining 530 (25.9%) patients did not receive anti-COVID-19 vaccination and were defined as the non-vaccinated subgroup. For all participants, Response Evaluation Criteria in Solid Tumor and Common Terminology Criteria for Adverse Events criteria were used to evaluate the efficacy and safety of camrelizumab treatment, respectively. Propensity score match analysis with the optimal pair matching was used to compare these criteria between the vaccinated and non-vaccinated subgroups. A total of 2048 eligible patients with cancer were included (median age 59 years, 27.6% female). Most patients (98.8%) had metastatic cancer of the lung, liver or intestinal tract. Aside from the PD-1 inhibitor treatment, 55.9% of patients received additional cancer therapies. 1518 (74.1%) patients received the BBIBP-CorV vaccine with only mild side effects reported. The remaining patients did not receive COVID-19 vaccination and had a statistically greater percentage of comorbidities. After matching for age, gender, cancer stage/types, comorbidity and performance status, 1060 patients (530 pairs) were selected for propensity score match analysis. This analysis showed no significant differences in overall response rate (25.3% vs 28.9%, p=0.213) and disease control rate (64.6% vs 67.0%, p=0.437) between vaccinated and non-vaccinated subgroups. Immune-related adverse events (irAEs) were reported in both subgroups after camrelizumab treatment. Among vaccinated patients who experienced irAEs, the median interval between the first dose of camrelizumab treatment and the first vaccine shot was ≤16 days. Compared with the non-vaccinated subgroup, irAEs in vaccinated patients were more frequently reported as mild (grade 1 or 2 irAEs; 33.8% vs 19.8%, p<0.001) and these patients were less likely to discontinue the PD-1 inhibitor treatment (4.2% vs 20.4%, p<0.001). Severe irAEs (grade 3 irAE or higher) related to camrelizumab treatment were reported, however no significant differences in the frequency of such events were observed between the vaccinated and non-vaccinated subgroups. The COVID-19 vaccine, BBIBP-CorV, did not increase severe anti-PD-1-related adverse events nor did it reduce the clinical efficacy of camrelizumab in patients with cancer. Thus, we conclude that patients with cancer need not suspend anti-PD-1 treatment during COVID-19 vaccination.
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spelling doaj-art-bf192d1bbf924353bb6a719c5ced78142025-08-20T02:11:30ZengBMJ Publishing GroupJournal for ImmunoTherapy of Cancer2051-14262022-03-0110310.1136/jitc-2021-004157Impact of COVID-19 vaccination on the use of PD-1 inhibitor in treating patients with cancer: a real-world studyYang Yang0Junping Yin1Jian Li2Bo Liu3Ming Li4Qiao Huang5Xianglin Yuan6Christian Kurts7Guangyuan Hu8Qi Mei9Xi Tang10Alexander Böhner11Amy Bryant12Department of Gastrointestinal Surgery, Sichuan University West China Hospital, Chengdu, Sichuan, China1Research Center Borstel, Borstel, GermanyState Key Laboratory of Pathogen and Biosecurity, Academy of Military Medical Sciences, Beijing 100071, ChinaDepartment of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, ChinaDepartment of Oncology, Wuhan Pulmonary Hospital, Wuhan, Hubei, ChinaDepartment of Oncology, The First College of Clinical Medical Science, Yichang, Hubei, ChinaDepartment of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, ChinaInstitute of Molecular Medicine and Experimental Immunology, University Clinic of Rheinische Friedrich-Wilhelms-University, Bonn, GermanyDepartment of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, ChinaDepartment of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, ChinaDepartment of Oncology, Jingzhou Central Hospital, Jingzhou, Hubei, ChinaInstitute of Molecular Medicine and Experimental Immunology, University Clinic of Rheinische Friedrich-Wilhelms-University, Bonn, GermanyDepartment of Biomedical and Pharmaceutical Sciences, College of Pharmacy, Idaho State University, Meridian, Idaho, USAAnti-COVID-19 vaccination may have functional implications for immune checkpoint inhibitor treatment in patients with cancer. This study was undertaken to determine whether the safety or efficacy of anti-PD-1 therapy is reduced in patients with cancer during COVID-19 vaccination. A large multicenter observational study was conducted in 83 Chinese hospitals between January 28, 2021 and September 30, 2021. A total of 3552 patients were screened and 2048 eligible patients with cancer receiving PD-1 inhibitor treatment were recruited. All enrolled patients had received camrelizumab treatment alone or in conjunction with other cancer therapies. Among these, 1518 (74.1%) patients received the BBIBP-CorV vaccine and were defined as the vaccinated subgroup. The remaining 530 (25.9%) patients did not receive anti-COVID-19 vaccination and were defined as the non-vaccinated subgroup. For all participants, Response Evaluation Criteria in Solid Tumor and Common Terminology Criteria for Adverse Events criteria were used to evaluate the efficacy and safety of camrelizumab treatment, respectively. Propensity score match analysis with the optimal pair matching was used to compare these criteria between the vaccinated and non-vaccinated subgroups. A total of 2048 eligible patients with cancer were included (median age 59 years, 27.6% female). Most patients (98.8%) had metastatic cancer of the lung, liver or intestinal tract. Aside from the PD-1 inhibitor treatment, 55.9% of patients received additional cancer therapies. 1518 (74.1%) patients received the BBIBP-CorV vaccine with only mild side effects reported. The remaining patients did not receive COVID-19 vaccination and had a statistically greater percentage of comorbidities. After matching for age, gender, cancer stage/types, comorbidity and performance status, 1060 patients (530 pairs) were selected for propensity score match analysis. This analysis showed no significant differences in overall response rate (25.3% vs 28.9%, p=0.213) and disease control rate (64.6% vs 67.0%, p=0.437) between vaccinated and non-vaccinated subgroups. Immune-related adverse events (irAEs) were reported in both subgroups after camrelizumab treatment. Among vaccinated patients who experienced irAEs, the median interval between the first dose of camrelizumab treatment and the first vaccine shot was ≤16 days. Compared with the non-vaccinated subgroup, irAEs in vaccinated patients were more frequently reported as mild (grade 1 or 2 irAEs; 33.8% vs 19.8%, p<0.001) and these patients were less likely to discontinue the PD-1 inhibitor treatment (4.2% vs 20.4%, p<0.001). Severe irAEs (grade 3 irAE or higher) related to camrelizumab treatment were reported, however no significant differences in the frequency of such events were observed between the vaccinated and non-vaccinated subgroups. The COVID-19 vaccine, BBIBP-CorV, did not increase severe anti-PD-1-related adverse events nor did it reduce the clinical efficacy of camrelizumab in patients with cancer. Thus, we conclude that patients with cancer need not suspend anti-PD-1 treatment during COVID-19 vaccination.https://jitc.bmj.com/content/10/3/e004157.full
spellingShingle Yang Yang
Junping Yin
Jian Li
Bo Liu
Ming Li
Qiao Huang
Xianglin Yuan
Christian Kurts
Guangyuan Hu
Qi Mei
Xi Tang
Alexander Böhner
Amy Bryant
Impact of COVID-19 vaccination on the use of PD-1 inhibitor in treating patients with cancer: a real-world study
Journal for ImmunoTherapy of Cancer
title Impact of COVID-19 vaccination on the use of PD-1 inhibitor in treating patients with cancer: a real-world study
title_full Impact of COVID-19 vaccination on the use of PD-1 inhibitor in treating patients with cancer: a real-world study
title_fullStr Impact of COVID-19 vaccination on the use of PD-1 inhibitor in treating patients with cancer: a real-world study
title_full_unstemmed Impact of COVID-19 vaccination on the use of PD-1 inhibitor in treating patients with cancer: a real-world study
title_short Impact of COVID-19 vaccination on the use of PD-1 inhibitor in treating patients with cancer: a real-world study
title_sort impact of covid 19 vaccination on the use of pd 1 inhibitor in treating patients with cancer a real world study
url https://jitc.bmj.com/content/10/3/e004157.full
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