DOI QR코드

DOI QR Code

COVID-19 Vaccination in Patients with Gastrointestinal Cancer Receiving Chemotherapy

항암치료를 받는 소화기 암환자에서 코로나바이러스 감염증-19 백신접종

  • Jonghyun Lee (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Dong Uk Kim (Department of Internal Medicine, Pusan National University School of Medicine)
  • 이종현 (부산대학교 의과대학 내과학교실) ;
  • 김동욱 (부산대학교 의과대학 내과학교실)
  • Received : 2022.09.22
  • Accepted : 2022.10.30
  • Published : 2022.12.01

Abstract

In 2019, coronavirus disease (COVID-19), which originated in Wuhan, has spread worldwide. In most people, COVID-19 symptoms are not severe. However, the mortality rate and severity were high in risk groups such as in older people and patients with underlying diseases. As patients with cancer are one of the risk groups, the vaccination for COVID-19 is emphasized in these patients. However, COVID-19 vaccines are not tested enough in special groups such as in patients with cancer because these vaccines are developed at an unprecedented speed. This causes confusion about whether patients undergoing chemotherapy should be vaccinated or not. In this study, international guidelines and studies were reviewed. Most of the studies recommended vaccination. No evidences of any negative effects for the efficacy or safety were recorded in patients undergoing cytotoxic, targeted, and immune agents. However, in critical conditions such as cytopenia, vaccination must be decided according to the patient's condition. COVID-19 vaccines were also recommended for patients on surgery or radiation therapy. If possible, vaccine is given before surgery to avoid confusion between surgical complications and side effects of the vaccine. The radiation recall phenomenon after vaccination has been reported in some cases of radiation therapy. Clinicians should consider these situations before vaccinating each patient. We hope that clearer guidelines will be established by accumulating verified data.

Keywords

References

  1. Coronaviridae Study Group of the International Committee on Taxonomy of Viruses. The species Severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2. Nat Microbiol 2020;5:536-544. https://doi.org/10.1038/s41564-020-0695-z 
  2. Williamson EJ, Walker AJ, Bhaskaran K, et al. Factors associated with COVID-19-related death using OpenSAFELY. Nature 2020;584:430-436. https://doi.org/10.1038/s41586-020-2521-4 
  3. Moghadas SM, Vilches TN, Zhang K, et al. The impact of vaccination on coronavirus disease 2019 (COVID-19) outbreaks in the United States. Clin Infect Dis 2021;73:2257-2264. https://doi.org/10.1093/cid/ciab079 
  4. Yang L, Chai P, Yu J, Fan X. Effects of cancer on patients with COVID-19: a systematic review and meta-analysis of 63,019 participants. Cancer Biol Med 2021;18:298-307. https://doi.org/10.20892/j.issn.2095-3941.2020.0559 
  5. Li Q, Chen L, Li Q, et al. Cancer increases risk of in-hospital death from COVID-19 in persons <65 years and those not in complete remission. Leukemia 2020;34:2384-2391. https://doi.org/10.1038/s41375-020-0986-7 
  6. Lee LYW, Cazier JB, Starkey T, et al. COVID-19 prevalence and mortality in patients with cancer and the effect of primary tumour subtype and patient demographics: a prospective cohort study. Lancet Oncol 2020;21:1309-1316. Erratum in: Lancet Oncol 2020;21:e462. https://doi.org/10.1016/S1470-2045(20)30442-3 
  7. Pinato DJ, Tabernero J, Bower M, et al. Prevalence and impact of COVID-19 sequelae on treatment and survival of patients with cancer who recovered from SARS-CoV-2 infection: evidence from the OnCovid retrospective, multicentre registry study. Lancet Oncol 2021;22:1669-1680. https://doi.org/10.1016/S1470-2045(21)00573-8 
  8. Desai A, Gainor JF, Hegde A, et al. COVID-19 vaccine guidance for patients with cancer participating in oncology clinical trials. Nat Rev Clin Oncol 2021;18:313-319. Erratum in: Nat Rev Clin Oncol 2021;18:320. https://doi.org/10.1038/s41571-021-00487-z 
  9. Shehata MA, Karim NA. Influenza vaccination in cancer patients undergoing systemic therapy. Clin Med Insights Oncol 2014;8:57-64. https://doi.org/10.4137/CMO.S13774 
  10. Shah MK, Kamboj M. Immunizing cancer patients: which patients? Which vaccines? When to give? Oncology (Williston Park) 2018;32:254-258, C3. 
  11. Sakuraba A, Luna A, Micic D. Serologic response following SARS-COV2 vaccination in patients with cancer: a systematic review and meta-analysis. J Hematol Oncol 2022;15:15. https://doi.org/10.1186/s13045-022-01233-3 
  12. Becerril-Gaitan A, Vaca-Cartagena BF, Ferrigno AS, et al. Immunogenicity and risk of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection after Coronavirus Disease 2019 (COVID-19) vaccination in patients with cancer: a systematic review and meta-analysis. Eur J Cancer 2022;160:243-260. https://doi.org/10.1016/j.ejca.2021.10.014 
  13. Chiarella SE, Jenkins SM, Smith CY, et al. Predictors of seroconversion after coronavirus disease 2019 vaccination. Ann Allergy Asthma Immunol 2022;129:189-193. https://doi.org/10.1016/j.anai.2022.05.026 
  14. Cavanna L, Citterio C, Biasini C, et al. COVID-19 vaccines in adult cancer patients with solid tumours undergoing active treatment: seropositivity and safety. A prospective observational study in Italy. Eur J Cancer 2021;157:441-449. https://doi.org/10.1016/j.ejca.2021.08.035 
  15. Rousseau B, Loulergue P, Mir O, et al. Immunogenicity and safety of the influenza A H1N1v 2009 vaccine in cancer patients treated with cytotoxic chemotherapy and/or targeted therapy: the VACANCE study. Ann Oncol 2012;23:450-457. https://doi.org/10.1093/annonc/mdr141 
  16. Keam B, Kim MK, Choi Y, et al. Optimal timing of influenza vaccination during 3-week cytotoxic chemotherapy cycles. Cancer 2017;123:841-848. https://doi.org/10.1002/cncr.30468 
  17. National Comprehensive Cancer Network® (NCCN®). Recommendations of the NCCN® advisory committee on COVID-19 vaccination and pre-exposure prophylaxis. NCCN®; 2022. 
  18. European Society for Medical Oncology (ESMO). ESMO statements on vaccination against COVID-19 in people with cancer. Lugano: ESMO; 2021. 
  19. Mulder SF, Jacobs JF, Olde Nordkamp MA, et al. Cancer patients treated with sunitinib or sorafenib have sufficient antibody and cellular immune responses to warrant influenza vaccination. Clin Cancer Res 2011;17:4541-4549. https://doi.org/10.1158/1078-0432.CCR-11-0253 
  20. Oosting SF, van der Veldt AAM, GeurtsvanKessel CH, et al. mRNA-1273 COVID-19 vaccination in patients receiving chemotherapy, immunotherapy, or chemoimmunotherapy for solid tumours: a prospective, multicentre, non-inferiority trial. Lancet Oncol 2021;22:1681-1691. https://doi.org/10.1016/S1470-2045(21)00574-X 
  21. Keam B, Kang CK, Jun KI, et al. Immunogenicity of influenza vaccination in patients with cancer receiving immune checkpoint inhibitors. Clin Infect Dis 2020;71:422-425. https://doi.org/10.1093/cid/ciz1092 
  22. Centers for Disease Control and Prevention (CDC). Pfizer-BioNTech COVID-19 vaccine reactions & adverse events. Atlanta: CDC; 2021. 
  23. Soyfer V, Gutfeld O, Shamai S, Schlocker A, Merimsky O. COVID-19 vaccine-induced radiation recall phenomenon. Int J Radiat Oncol Biol Phys 2021;110:957-961. https://doi.org/10.1016/j.ijrobp.2021.02.048 
  24. Stewart R, McDowell L. Radiation recall phenomenon following COVID-19 vaccination. Int J Radiat Oncol Biol Phys 2021;111:835-836. https://doi.org/10.1016/j.ijrobp.2021.06.023