Center of Excellence for Thoracic Oncology, The Tisch Cancer Institute, Icahn School of Medicine, at Mount Sinai, New York, New York.
Medical Oncology Unit, Azienda Ospedaliera Papardo (A.O. Papardo), Messina, Italy.
J Thorac Oncol. 2022 Feb;17(2):214-227. doi: 10.1016/j.jtho.2021.11.001. Epub 2021 Nov 10.
Patients with lung cancer are especially vulnerable to coronavirus disease 2019 (COVID-19) with a greater than sevenfold higher rate of becoming infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) COVID-19, a greater than threefold higher hospitalization rate with high complication rates, and an estimated case fatality rate of more than 30%. The reasons for the increased vulnerability are not known. In addition, beyond the direct impact of the pandemic on morbidity and mortality among patients with lung cancer, COVID-19, with its disruption of patient care, has also resulted in substantial impact on lung cancer screening and treatment/management.COVID-19 vaccines are safe and effective in people with lung cancer. On the basis of the available data, patients with lung cancer should continue their course of cancer treatment and get vaccinated against the SARS-CoV-2 virus. For unknown reasons, some patients with lung cancer mount poor antibody responses to vaccination. Thus, boosting vaccination seems urgently indicated in this subgroup of vulnerable patients with lung cancer. Nevertheless, many unanswered questions regarding vaccination in this population remain, including the magnitude, quality, and duration of antibody response and the role of innate and acquired cellular immunities for clinical protection. Additional important knowledge gaps also remain, including the following: how can we best protect patients with lung cancer from developing COVID-19, including managing care in patient with lung cancer and the home environment of patients with lung cancer; are there clinical/treatment demographics and tumor molecular demographics that affect severity of COVID-19 disease in patients with lung cancer; does anticancer treatment affect antibody production and protection; does SARS-CoV-2 infection affect the development/progression of lung cancer; and are special measures and vaccine strategies needed for patients with lung cancer as viral variants of concern emerge.
肺癌患者尤其容易感染 2019 年冠状病毒病（COVID-19），感染严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）COVID-19 的风险高出七倍以上，住院率高出三倍以上，且并发症发生率高，估计病死率超过 30%。其易感性增加的原因尚不清楚。此外，除了 COVID-19 对肺癌患者发病率和死亡率的直接影响外，由于其对患者护理的干扰，也对肺癌筛查和治疗/管理产生了重大影响。COVID-19 疫苗对肺癌患者是安全有效的。基于现有数据，肺癌患者应继续进行癌症治疗，并接种 SARS-CoV-2 病毒疫苗。由于未知原因，一些肺癌患者对疫苗接种的抗体反应较差。因此，在这一脆弱的肺癌患者亚组中，迫切需要增强疫苗接种。然而，在这一人群中，关于疫苗接种仍存在许多未解决的问题，包括抗体反应的幅度、质量和持续时间，以及先天和获得性细胞免疫对临床保护的作用。此外，还存在一些重要的知识空白，包括：我们如何最好地保护肺癌患者免受 COVID-19 的侵害，包括管理肺癌患者的护理以及肺癌患者的家庭环境；是否存在临床/治疗特征和肿瘤分子特征影响肺癌患者 COVID-19 疾病的严重程度；抗癌治疗是否会影响抗体产生和保护；SARS-CoV-2 感染是否会影响肺癌的发展/进展；以及随着关注的病毒变体的出现，肺癌患者是否需要特殊措施和疫苗策略。
