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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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Korompoki E, Gavriatopoulou M, Kontoyiannis DP. COVID-19 Vaccines in Patients With Cancer—A Welcome Addition, but There Is Need for Optimization. JAMA Oncol. Published online May 13, 2021. doi:10.1001/jamaoncol.2021.1218
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