Luo Ping, Liu Jiasi, Wang Zhan, Liao Chenwei, She Lei, Zou Ting, Chen Juan, Liu Zhaoqian
Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, P. R. China.
Department of Clinical Pharmacology, Hunan Key Laboratory of Pharmacogenetics, and National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, P. R. China.
Hum Vaccin Immunother. 2025 Dec;21(1):2539593. doi: 10.1080/21645515.2025.2539593. Epub 2025 Aug 13.
The influence of COVID-19 vaccination on the efficacy and safety of immune checkpoint inhibitors (ICIs) in lung cancer treatment is not well understood. A cohort of 394 lung cancer patients treated with PD-1/PD-L1 inhibitors was analyzed. The incidence and types of irAEs were recorded, and the relationship between COVID-19 vaccination and progression-free survival (PFS) was assessed using univariate and multivariate analyses. Among the 394 patients, 44% (171 cases) experienced multiple irAEs, 29% (114 cases) had a single type of irAE, and 27% (108 cases) reported no adverse reactions. The most common irAEs included thyroid-related events (hypothyroidism: 18%, hyperthyroidism: 11%), skin toxicity (16%), cardiovascular toxicity (14%), skeletal muscle toxicity (8%), glycemic endocrine toxicity (7%), and pneumonia (6%). COVID-19 vaccination was associated with a decrease in the incidence of immune-related arthritis and myocarditis, while other irAEs such as pneumonia, dermatitis/rash, myositis, oculopathy, diabetes, colitis, nephritis, hypothyroidism, hyperthyroidism, hypophysitis, and transaminitis were unaffected. No significant correlation was found between COVID-19 vaccination and PFS in both univariate and multivariate analyses. COVID-19 vaccination does not increase the incidence of irAEs nor affect the PFS of lung cancer patients receiving ICIs treatment.
新型冠状病毒肺炎（COVID-19）疫苗接种对肺癌治疗中免疫检查点抑制剂（ICI）疗效和安全性的影响尚不清楚。分析了一组394例接受PD-1/PD-L1抑制剂治疗的肺癌患者。记录免疫相关不良反应（irAE）的发生率和类型，并采用单因素和多因素分析评估COVID-19疫苗接种与无进展生存期（PFS）之间的关系。在394例患者中，44%（171例）发生多种irAE，29%（114例）发生单一类型的irAE，27%（108例）未报告不良反应。最常见的irAE包括甲状腺相关事件（甲状腺功能减退：18%，甲状腺功能亢进：11%）、皮肤毒性（16%）、心血管毒性（14%）、骨骼肌毒性（8%）、血糖内分泌毒性（7%）和肺炎（6%）。COVID-19疫苗接种与免疫相关关节炎和心肌炎的发生率降低有关，而其他irAE如肺炎、皮炎/皮疹、肌炎、眼病、糖尿病、结肠炎、肾炎、甲状腺功能减退、甲状腺功能亢进、垂体炎和转氨酶升高则未受影响。单因素和多因素分析均未发现COVID-19疫苗接种与PFS之间存在显著相关性。COVID-19疫苗接种不会增加irAE的发生率，也不会影响接受ICI治疗的肺癌患者的PFS。
