COVID-19 vaccination may improve efficacy of treatment for nasopharyngeal cancer
Patients with nasopharyngeal cancer who underwent COVID-19 vaccination had a better response to a combination of anti-PD-1 therapy and chemotherapy than their unvaccinated counterparts, according to a letter published in Annals of Oncology.
In addition, patients who received the CoronaVac COVID-19 vaccine (Sinovac Biotech) did not have a higher rate of adverse events from the cancer treatment than those who did not receive the vaccine.
Background
Anti-PD-1 therapy has shown efficacy among patients with nasopharyngeal cancer. However, concerns arose during the pandemic about whether anti-PD-1 blockade would interfere with COVID-19 vaccination, as they stimulate the same immune response involving the PD-1 receptor.
“It was feared that the vaccine would not be compatible with anti-PD-1 therapy,” Jian Li, PhD, a bioinformatics scientist at Institute of Molecular Medicine and Experimental Immunology at the University Hospital Bonn, said in a press release. “This risk is especially true for nasopharyngeal cancer, which, like the [SARS-CoV-2] virus, affects the upper respiratory tract.”
Methodology
The study included 1,537 patients with nasopharyngeal cancer (median age, 45 years; 76.1% male) in a recurrent metastatic stage who received first-line anti-PD-1 therapy at the time of relapse or diagnosis of metastasis. Most received concomitant anti-PD-1 therapy and chemotherapy.
Researchers separated the patients into two subgroups: those who received the CoronaVac vaccine, with a median interval of 105 days between vaccination and the first dose of anti-PD-1 treatment (n = 373), and those who did not receive the COVID-19 vaccine (n = 1,164).
Results
Vaccination against COVID-19 not only did not interfere with anti-PD-1 treatment, but patients in the vaccinated subgroup had a higher objective response rate (59% vs. 38.8%; P < .001) and disease control rate (80.2% vs. 74.7%; P = .031) following anti-PD-1 treatment than those in the nonvaccinated subgroup.
“Surprisingly, they responded significantly better to anti-PD-1 therapy than the unvaccinated patients,” Christian Kurts, director of Institute of Molecular Medicine and Experimental Immunology, said in the press release.
Patients in the vaccinated subgroup had a higher likelihood of experiencing mild immune-related adverse effects (73.6% vs. 60.1%) and mild vaccine-related adverse effects (21.7% vs. 8.2%). However, they noted no significant difference between the groups in severe immune-related adverse effects.
Next steps
Researchers planned to evaluate the connection between COVID-19 vaccination and increased efficacy of anti-PD-1 therapy with chemotherapy in a larger cohort of patients with recurrent metastatic nasopharyngeal cancer.
“We assume that vaccination activates certain immune cells, which then attack the tumor,” Qi Mei, MD, of Shanxi University Hospital, said in the press release. “We will now investigate this hypothesis further.”
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