COVID-19 Vaccines in Patients With Cancer—A Welcome Addition, but There Is Need for Optimization | Oncology | JAMA Oncology | JAMA Network
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May 13, 2021

COVID-19 Vaccines in Patients With Cancer—A Welcome Addition, but There Is Need for Optimization

Author Affiliations
  • 1Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
  • 2Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, Texas
JAMA Oncol. Published online May 13, 2021. doi:10.1001/jamaoncol.2021.1218

The urgency of the COVID-19 pandemic led to the scientific triumph of rapid vaccine development against SARS-CoV-2 within less than a year, a period much faster to traditional vaccine development, which spans decades. That impressive speed is credited to a novel approach to vaccine development, with vaccines encoding genetic information in the form of messenger RNA (mRNA) and inducing the body to produce neutralizing antibodies against the SARS-CoV-2 spike protein, the attachment protein for viral entry to cells via the angiotensin-converting enzyme–2 receptor. There are currently 2 mRNA vaccines (Pfizer-BioNTech and Moderna) and 2 adenovirus-based vaccines (Oxford–AstraZeneca and Johnson & Johnson) for which phase 3 placebo-controlled randomized clinical trials (RCTs) published in high-profile journals show an impressive efficacy, although real world effectiveness remains to be further validated in postlicense assessment.1 As very few patients with underlying cancer were enrolled in those studies,2 many unanswered questions remain about the risk-benefit ratio of these new COVID-19 vaccines in patients with cancer.

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    2 Comments for this article
    Varias incógnitas por resolver
    Andrés Bonilla |
    Interesante articulo, queda por discutir la importancia de la vacunación en los pacientes y si se requieran mayor numero de dosis en aquellos con tumores hematolinfoides que hagan que el establecimiento de inmunidad específica tarde en formarse.

    Parece fundamental estudiar las vacuna de RNA en pacientes con cáncer y su efectividad comparada.
    Need to confirm the safety of COVID-19 vaccination in cancer patients
    takuma hayashi, MBBS, DMSci, GMRC, PhD | National Hospital Organization Kyoto Medical Center
    There is an increased risk of death from the new coronavirus infectious disease 2019 (COVID-19) in cancer patients who have been or are being treated with systemic chemotherapy. Therefore, cancer patients are a high priority group for COVID-19 vaccination. However, no safety and efficacy data are available for the COVID-19 vaccine in cancer patients. In addition, cancer treatment experts have pointed out that COVID-19 vaccination may induce or enhance immune-related adverse events (irAEs) in patients, which have been treating with immune checkpoint inhibitors (ICIs).

    In the guidelines of the Japan Society of Clinical Oncology, the following contents are expressed. />
    In general, immune checkpoint inhibitors have a long half-life in the body of patient with cancer, so the antiviral efficacy and safety of COVID-19 vaccination (BNT162b2) are unlikely to be affected by the timing of COVID-19 vaccination. Therefore, at this time, COVID-19 vaccination for patients with cancer is recommended during treatment with immune checkpoint inhibitors. However, fever is observed a few days after the COVID-19 vaccination, so Patients should refrain from COVID-19 vaccination within a few days prior to the start of treatment with immune checkpoint inhibitors.

    So that cancer patients can be vaccinated with COVID-19 vaccine with confidence, medical researchers must carry out clinical studies with large cohorts to obtain safety and efficacy data for the COVID-19 vaccine in patients with cancer.

    Dr. Hayashi T. Dr. Yaegashi N and Dr. Konishi I.
    National Hospital Organization Kyoto Medical Center