Impact of COVID-19 vaccine type on the efficacy and safety of Nivolumab in patients with metastatic non-small-cell lung cancer: A multicenter study

Abstract

Background/Aim: The effect of COVID-19 vaccine type on the outcomes of therapy immune checkpoint inhibitors remains unclear, and concerns persist regarding whether mRNA-based vaccines may negatively impact treatment efficacy or increase immune-related toxicity. This study aimed to evaluate the association between COVID-19 vaccination type and the efficacy and safety of nivolumab in patients with metastatic non-small-cell lung cancer (NSCLC).

Patients and Methods: We retrospectively analyzed 138 patients with driver-negative metastatic NSCLC treated with second-line nivolumab. Patients were classified as receiving virion-based (Sinovac) only, mRNA-based only, or both types of vaccines. Treatment response, progression-free survival, objective response rate, clinical benefit rate clinical benefit rate and immune-related adverse events were compared.

Results: The overall response and clinical benefit rates were similar across vaccination groups, with no significant differences observed (p=0.38 and p=0.16, respectively). Median progression-free survival did not differ significantly among the different groups (p=0.39). The incidence of any-grade and grade 3-4 immune-related adverse events was comparable across groups, although grade 1-2 immune-related adverse events were more frequent among patients who had received at least one dose of Sinovac.

Conclusion: In patients with metastatic NSCLC receiving second-line nivolumab, the efficacy and safety profile of nivolumab did not differ according to the type of COVID-19 vaccine patients had received prior to therapy.