4.8 Article

Cytokine release syndrome in a patient with colorectal cancer after vaccination with BNT162b2

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NATURE MEDICINE
卷 27, 期 8, 页码 1362-+

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NATURE PORTFOLIO
DOI: 10.1038/s41591-021-01387-6

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资金

  1. Royal Marsden NHS Foundation Trust
  2. Francis Crick Institute
  3. Cancer Research UK [FC010110, FC0010988, FC001218, FC001030, FC001099, FC001002, FC001169]
  4. UK Medical Research Council [FC010110, FC0010988, FC001218, FC001030, FC001099, FC001002, FC001169]
  5. Wellcome Trust [FC010110, FC0010988, FC001218, FC001030, FC001099, FC001002]
  6. Royal Marsden Cancer Charity Programme [RMCC32]
  7. National Institute for Health Research Biomedical Research Centre at the Royal Marsden Hospital
  8. Institute of Cancer Research [A109]

向作者/读者索取更多资源

A rare case of cytokine release syndrome in a cancer patient following COVID-19 vaccination suggests a potential vaccine-related adverse event. While mRNA vaccines have not been linked to CRS, cancer patients are still recommended for COVID-19 vaccination as the benefit-risk profile remains favorable. Further prospective pharmacovigilance data are needed in this population to better understand any potential risks.
A rare case of cytokine release syndrome in a patient on anti-PD-1 blockade that was likely related to BNT162b2 vaccination supports prospective monitoring of patients with cancer after COVID-19 vaccine administration. Patients with cancer are currently prioritized in coronavirus disease 2019 (COVID-19) vaccination programs globally, which includes administration of mRNA vaccines. Cytokine release syndrome (CRS) has not been reported with mRNA vaccines and is an extremely rare immune-related adverse event of immune checkpoint inhibitors. We present a case of CRS that occurred 5 d after vaccination with BTN162b2 (tozinameran)-the Pfizer-BioNTech mRNA COVID-19 vaccine-in a patient with colorectal cancer on long-standing anti-PD-1 monotherapy. The CRS was evidenced by raised inflammatory markers, thrombocytopenia, elevated cytokine levels (IFN-gamma/IL-2R/IL-18/IL-16/IL-10) and steroid responsiveness. The close temporal association of vaccination and diagnosis of CRS in this case suggests that CRS was a vaccine-related adverse event; with anti-PD1 blockade as a potential contributor. Overall, further prospective pharmacovigillence data are needed in patients with cancer, but the benefit-risk profile remains strongly in favor of COVID-19 vaccination in this population.

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