Side effects of COVID-19 vaccinations in patients treated for breast cancer

Juhel, Brooke; Brunelle, Cheryl L.; Bernstein, Madison C; Smith, Leanne; Jung, Amanda W.; Ababneh, Hazim; Hausman, Elizabeth K; Bucci, Loryn K; Bernstein, Tess; Naoum, George E.; Taghian, Alphonse G.

doi:10.1007/s10238-023-01050-z

Cited by 4 publications

(3 citation statements)

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“…The epidemiological and clinical features of breast cancer diagnosis make these patients the most relevant oncology population facing the current and future implications of the COVID-19 pandemic. Despite evidence of a favorable safety profile (46), hesitation toward booster vaccinations remains higher than in the general population (47). Extensive studies have conclusively established that additional vaccinations provide the best protection against mortality and serious complications related to COVID-19 in high-risk recipients (48,49).…”

Section: Discussionmentioning

confidence: 99%

Immune responses and clinical outcomes following the third dose of SARS-CoV-2 mRNA-BNT162b2 vaccine in advanced breast cancer patients receiving targeted therapies: a prospective study

Nelli,

Fabbri,

Botticelli

et al. 2023

Front. Oncol.

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PurposeMetastatic breast cancer patients are the most prevalent oncology population with advanced disease facing COVID-19 pandemic. Immune responses after mRNA-based vaccination during treatment with CDK4/6 inhibitors or HER2-directed agents remain unclear. We conducted a prospective analysis to elucidate changes in antibody titers and lymphocyte counts following full course of mRNA-BNT162b2 (tozinameran) vaccination in recipients undergoing these targeted therapies.MethodsPatients who had received a booster dosing and had been treated for at least 6 months were eligible. Antibody titers against SARS-CoV-2 spike protein were measured at four subsequent time points. Immunophenotyping of circulating lymphocytes was performed before the third dose of tozinameran and four weeks later to quantify the absolute counts of CD3+CD4+ T-helper cells, CD3+CD8+ T-cytotoxic cells, CD19+ B cells, and CD56+CD16+ NK cells. We also assessed the incidence of breakthrough infections and investigated whether immune changes affect time-to-treatment failure (TTF) after booster vaccination.ResultsThe current analysis included 69 patients, of whom 38 (55%) and 31 (45%) were being treated with CDK4/6 inhibitors and HER2-targeted therapies, respectively. All participants received a third dose of tozinameran between September 23 and October 7, 2021. Multivariate analysis revealed that CDK4/6 inhibition predicted a significantly impaired humoral response after the booster dose. This detrimental effect was also evident for T-helper cell counts before the third immunization, but it disappeared in the subsequent evaluation. After a median follow-up of 22.3 months, we observed 19 (26%) cases of COVID-19 outbreaks, all experiencing favorable clinical outcomes. Univariate analysis showed a significant association between the onset of SARS-CoV-2 infections and the use of CDK4/6 inhibitors, as well as with an impaired antibody and T-helper cell response. Only the last two covariates remained independent predictors after multivariate testing. Dynamic variations in antibody titers and T-helper cell counts did not affect TTF in multivariate regression analysis.ConclusionsOur results confirm that the immune response to tozinameran is impaired by CDK4/6 inhibitors, increasing the odds of breakthrough infections despite the third vaccine dose. Current evidence recommends maintaining efforts to provide booster immunizations to the most vulnerable cancer patients, including those with advanced breast cancer undergoing CDK4/6 inhibition.

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Section: Discussionmentioning

confidence: 99%

Immune responses and clinical outcomes following the third dose of SARS-CoV-2 mRNA-BNT162b2 vaccine in advanced breast cancer patients receiving targeted therapies: a prospective study

Nelli,

Fabbri,

Botticelli

et al. 2023

Front. Oncol.

View full text Add to dashboard Cite

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“…Dear Editor, we would like to share ideas on the publication “Side effects of COVID-19 vaccinations in patients treated for breast cancer [ 1 ]” Juhel et al present side symptoms mentioned by a group of breast cancer patients. In total 4945 women who underwent treatment for breast cancer and were subsequently examined for breast cancer-related lymphedema were emailed a link to a survey [ 1 ]. According to Juhel et al, the most common side effects were soreness at the injection site, fatigue, generalized muscle soreness, headaches, and chills.…”

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confidence: 99%

“…According to Juhel et al, the most common side effects were soreness at the injection site, fatigue, generalized muscle soreness, headaches, and chills. The median duration of these side effects was less than 2 days, and the axilla on the side of the vaccine was where lymph node swelling most frequently occurred [ 1 ]. According to Juhel et al, this data will help with patient education about upcoming doses of vaccines, including assurances about the adverse effects to anticipate, notably lymph node enlargement that may affect mammograms after immunization [ 1 ].…”

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confidence: 99%