Effects of COVID-19 vaccination on irAEs and prognosis in lung cancer patients receive PD-(L)1 inhibitors

Abstract

The influence of COVID-19 vaccination on the efficacy and safety of immune checkpoint inhibitors (ICIs) in lung cancer treatment is not well understood. A cohort of 394 lung cancer patients treated with PD-1/PD-L1 inhibitors was analyzed. The incidence and types of irAEs were recorded, and the relationship between COVID-19 vaccination and progression-free survival (PFS) was assessed using univariate and multivariate analyses. Among the 394 patients, 44% (171 cases) experienced multiple irAEs, 29% (114 cases) had a single type of irAE, and 27% (108 cases) reported no adverse reactions. The most common irAEs included thyroid-related events (hypothyroidism: 18%, hyperthyroidism: 11%), skin toxicity (16%), cardiovascular toxicity (14%), skeletal muscle toxicity (8%), glycemic endocrine toxicity (7%), and pneumonia (6%). COVID-19 vaccination was associated with a decrease in the incidence of immune-related arthritis and myocarditis, while other irAEs such as pneumonia, dermatitis/rash, myositis, oculopathy, diabetes, colitis, nephritis, hypothyroidism, hyperthyroidism, hypophysitis, and transaminitis were unaffected. No significant correlation was found between COVID-19 vaccination and PFS in both univariate and multivariate analyses. COVID-19 vaccination does not increase the incidence of irAEs nor affect the PFS of lung cancer patients receiving ICIs treatment.