Vaccination and Immune Checkpoint Inhibitors

Abstract

Introduction: Immune checkpoint inhibitors (ICIs) have become part of cancer treatments. Their main side effects are immune-related adverse events (irAEs). So far, there has been no recommendation regarding routine vaccinations during ICIs treatment. Clinicians are aware of the risk of irAEs increases in this specific situation. The aim of this review of literature is to summarize the main studies about vaccination and ICIs interactions. Methods: A systematic assessment of literature articles was performed by searching in PubMed (MEDLINE), and major oncology meeting following PRISMA guidelines. Results: This review highlights the lack of literature. Indeed, most of the studies published were about influenza vaccination. Vaccination for patients under ICIs causes a humoral response and seems to be associated with an increase rate of seroconversion. Interestingly vaccination may provoke irAEs in ICIs-treated patients. So far, inactivated vaccines have not been contraindicated during ICI treatment. Conclusion: Larger prospective studies are needed in order to define a consensus on the use of vaccines under immunotherapy.

Influenza vaccination in cancer patients receiving immune checkpoint inhibitors: A systematic review

“…Despite these limitations, and in line with previous reports, 33 , 34 the results of our systematic review support influenza vaccination in patients with cancer receiving immune checkpoint inhibitor therapy. These results are particularly relevant in the context of the SARS‐CoV‐2 pandemic.…”

COVID-19 mRNA vaccines and immune-related adverse events in cancer patients treated with immune checkpoint inhibitors

“…However, the VAERS is limited by its passive reporting system and cannot be used to establish causal effects of a given vaccine, and cannot establish frequency data. Our study helps supplement the limited data available regarding the safety and risk of irAE of vaccination among patients with cancer receiving ICIs 7 , 8 . Considering the high mortality rate from COVID-19 among cancer patients 1 , the benefit of COVID-19 vaccination exceeds the hypothetical increased risk of irAEs for patients receiving ICIs, which appears minimal or non-existent in this and other series.…”

Severe cutaneous adverse reaction following COVID‐19 vaccination and immunotherapy: a second hit?

“…Therefore, T helper 17 responses appear to be pivotal in infections by microorganisms, as well as in chronic inflammatory diseases, including psoriasis. 3 There have been reports of eczematous rashes developing approximately 4 months after the start of the use of anti-IL-17A monoclonal agents, characterized by intense itching that leads to treatment interruption, 4 but their descriptions do not correspond clinically to the rashes observed in this case. Treatment with immunobiologics is not entirely contraindicated in patients with HTLV-1,…”

“…Vaccinations have been reported to raise the potential of immune-related adverse events (irAEs) in patients on CPIs. 3 Skin irAEs were the most commonly reported, followed by arthritis. 4 The Pfizer vaccine has been reported to cause mild skin reactions, which are generally selflimiting.…”