Recently, the COVID-19 epidemic has been surging, and major cities are climbing to the peak one by one. More and more medical staff and cancer patients are "sheeping" - some people joke that in the winter of 2022, the average temperature across the country may be a few degrees below zero, but the average body temperature of the people across the country is 38.5°C.
In this context, an old topic has become extremely hot: Can cancer patients, especially those undergoing treatment, get the new crown vaccine ? Will the COVID-19 vaccine be effective? What side effects will it have? Will it affect the efficacy of anti-cancer treatment?
This series of questions is really very complicated and there is no statistical answer. Today I will only answer one of the smaller questions: Are tumor patients who receive PD-1 immunotherapy suitable for the new crown vaccine?
First of all, existing preliminary research shows that: For tumor patients who are receiving PD-1 antibody immunotherapy, vaccination with the new crown vaccine has a certain effect, although the effect may be slightly less than that of ordinary people.
A multi-center retrospective study from Europe analyzed 240 advanced cancer patients who received PD-1 antibody treatment within 23 months of being diagnosed with the new coronavirus. Most of these patients were elderly, had underlying diseases, and had advanced refractory cancer. Therefore, the mortality rate after being infected with the new coronavirus is as high as 23.6%.
240 patients, 42 have received at least 2 doses of the new crown vaccine. Compared with those patients who have never received the new crown vaccine, the case fatality rate is significantly lower (28.1% and 4.8% respectively) , The proportion of hospitalizations due to new coronary pneumonia has also dropped significantly (63.2% and 27.5% respectively), The proportion of people requiring oxygen therapy due to new coronary pneumonia has also dropped significantly (41.5% vs 15.8%) .
After balancing the baseline characteristics between the two groups, the above conclusion remains unchanged.
In fact, there are many similar studies, all of which show that: For tumor patients receiving PD-1 antibody treatment, if there are no other contraindications or special circumstances, it is beneficial to actively vaccinate against the new coronavirus, which can significantly reduce the rate of severe illness and death caused by infection with the new coronavirus.
Secondly, when receiving the COVID-19 vaccine while receiving PD-1 antibody immunotherapy, adverse reactions related to the COVID-19 vaccine occurred, which were generally similar to those in the general population. In addition, vaccination with the COVID-19 vaccine did not aggravate the side effects caused by PD-1 antibody immunotherapy.
A retrospective analysis of 2,048 advanced cancer patients who received PD-1 antibody treatment from 83 hospitals in my country from January 28, 2021 to September 30, 2021, preliminarily confirmed the above conclusion.
Finally, will the COVID-19 vaccine affect the anti-cancer efficacy while receiving immunotherapy ?
Most previous studies have shown that the new coronavirus vaccine does not affect the efficacy of PD-1 antibodies. However, a recent study shows that taking the COVID-19 vaccine seems to improve the efficacy of PD-1 antibodies.
1,537 patients with advanced nasopharyngeal cancer who received PD-1 antibody treatment from 23 hospitals across the country were included in a retrospective analysis. Among them, 373 patients had received the new crown vaccine, and another 1 Among the 164 patients who had not been vaccinated against COVID-19 but had been vaccinated with vaccine and , the median time interval from vaccination to PD-1 antibody treatment was 105 days. The longest interval for patients was 154 days. Some patients received PD-1 antibodies first and then received the vaccine.
Compared with patients who have not received the vaccine, COVID-19 vaccination significantly improved the efficacy of PD-1 antibodies in the treatment of advanced nasopharyngeal cancer. The objective effective rate increased from 38.8% to 59.0%, and the disease control rate increased from 74.7% to 80.2%.
In summary, patients who are receiving or planning to receive PD-1 antibody immunotherapy can receive the COVID-19 vaccine as appropriate if their condition is stable and there are no other contraindications. Impact of COVID-19 vaccination on the use of PD-1 inhibitor in treating patients with cancer: a real-world study. J Immunother Cancer. 2022; 10(3): e004157.
[3]. Potentially improved response of COVID-19 vaccinated nasopharyngeal cancer patients to combination therapy with anti-PD-1 blockade and chemotherapy. Ann Oncol. 2022 Oct 7. doi: 10.1016/j.annonc.2022.10.002
