Cancer Patients Treated with Immunotherapy Can Safely Receive mRNA COVID-19 Vaccines, According to JNCCN Study

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National Comprehensive Cancer Network

Oct 17, 2022, 08:36 ET

Researchers find people undergoing treatment with immune checkpoint inhibitors who receive an mRNA COVID-19 vaccine are not at any greater risk of side effects from the vaccine or the immunotherapy.

PLYMOUTH MEETING, Pa., Oct. 17, 2022 /PRNewswire/ -- New research published in the October 2022 issue of JNCCN—Journal of the National Comprehensive Cancer Network confirms the safety of mRNA vaccines in people with cancer undergoing immunotherapy treatment. The researchers analyzed the frequency of side effects (also referred to as immune-related adverse events, or irAEs) in 408 patients receiving immune checkpoint inhibitor (ICI) therapy between January 16 and March 27, 2021. They found no increase in type, frequency, or severity of side effects from those receiving both immunotherapy and the vaccine at the same time.

"We see no evidence to suggest that taking the COVID-19 vaccine increases the risk of immune-related adverse events in newly or previously ICI-treated patients. Also, the vaccine will not disrupt treatment or lead to early discontinuation," said senior author Mini Kamboj, MD, Chief Medical Epidemiologist, Infection Control at Memorial Sloan Kettering Cancer Center (MSK). "Vaccines continue to offer strong protection from severe COVID-19 for all variants, and patients are highly encouraged to stay up-to-date on their COVID-19 vaccination."

This research supports NCCN's recommendations for COVID-19 vaccination in people with cancer. The current guidance acknowledges that there is an acceptable safety profile for COVID-19 vaccination in people being treated with immunotherapy, while also calling for more data. The newly-published study in JNCCN can help answer that call. The frequently-updated, evidence-based, expert consensus recommendations can be found at NCCN.org/covid-19.

The JNCCN article cites a previous study¹ that found approximately one-fifth of patients receiving ICI treatment were reluctant to get vaccinated against COVID-19 due to fear of added side effects.

"The main catalyst for this study was vaccine hesitancy among patients on immunotherapy and the uncertainty among treating clinicians on how to address these concerns," explained lead author Adam Widman, MD, also with MSK. "This was surprising, since there is overwhelming evidence of higher risk for COVID-19-infection related complications in patients actively receiving cancer treatment. We felt it was essential to share our experience and encourage vaccine uptake in this vulnerable population."

"It is encouraging that patients treated with immunotherapy who were also vaccinated for COVID-19 did not experience immune checkpoint toxicity at a greater rate than those patients who received immunotherapy and were unvaccinated," commented Bryan J. Schneider, MD, University of Michigan Rogel Cancer Center, who is Vice-Chair of the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines^®) Panel for Management of Immunotherapy-Related Toxicity, and was not involved in this research. "The worry that side effects would increase during immune checkpoint therapy may have led patients or providers away from routine vaccination; however, recent reviews have not supported this concern. Patients should receive mRNA-based vaccines per institutional guidelines. This recommendation is also reflected in the NCCN Guidelines for Management of Immunotherapy-Related Toxicities."

The NCCN Guidelines for Management of Immunotherapy-Related Toxicities, versions of these guidelines for patients and caregivers, as well as a one-page infographic to help patients and caregivers recognize irAEs are all available for free at NCCN.org.

To read the entire study, visit JNCCN.org. Complimentary access to "Immune-Related Adverse Events Among COIVD-19-Vaccinated Patients with Cancer Receiving Immune Checkpoint Blockade" is available until January 10, 2023.

Addressing Bias in Cancer Care

The October 2022 issue of JNCCN also features original research from NCCN, the American Cancer Society Cancer Action Network, the National Minority Quality Forum, and Public Opinion Strategies on patient, caregiver, and oncologist experiences with and perceptions of racial bias and discrimination in cancer care delivery. The survey results show patients who are people of color are more likely to report negative experiences with cancer care teams than their white counterparts. The researchers highlight specific areas for addressing structural racism and improving equity in cancer treatment and outcomes. Read the entire study and a related commentary at JNCCN.org, and learn more about the Elevating Cancer Equity initiative behind the survey at NCCN.org/policy.

About JNCCN—Journal of the National Comprehensive Cancer Network
More than 25,000 oncologists and other cancer care professionals across the United States read JNCCN—Journal of the National Comprehensive Cancer Network. This peer-reviewed, indexed medical journal provides the latest information about innovation in translational medicine, and scientific studies related to oncology health services research, including quality care and value, bioethics, comparative and cost effectiveness, public policy, and interventional research on supportive care and survivorship. JNCCN features updates on the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines^®), review articles elaborating on guidelines recommendations, health services research, and case reports highlighting molecular insights in patient care. JNCCN is published by Harborside. Visit JNCCN.org. To inquire if you are eligible for a FREE subscription to JNCCN, visit NCCN.org/jnccn/subscribe. Follow JNCCN on Twitter @JNCCN.

About the National Comprehensive Cancer Network
The National Comprehensive Cancer Network^® (NCCN^®) is a not-for-profit alliance of leading cancer centers devoted to patient care, research, and education. NCCN is dedicated to improving and facilitating quality, effective, equitable, and accessible cancer care so all patients can live better lives. The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines^®) provide transparent, evidence-based, expert consensus recommendations for cancer treatment, prevention, and supportive services; they are the recognized standard for clinical direction and policy in cancer management and the most thorough and frequently-updated clinical practice guidelines available in any area of medicine. The NCCN Guidelines for Patients^® provide expert cancer treatment information to inform and empower patients and caregivers, through support from the NCCN Foundation^®. NCCN also advances continuing education, global initiatives, policy, and research collaboration and publication in oncology. Visit NCCN.org for more information and follow NCCN on Facebook @NCCNorg, Instagram @NCCNorg, and Twitter @NCCN.

¹ Waissengrin B, Agbarya A, Safadi E, et al. Short-term safety of the BNT162b2 mRNA COVID-19 vaccine in patients with cancer treated with immune checkpoint inhibitors. Lancet Oncol 2021;22:581-583.

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SOURCE National Comprehensive Cancer Network