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

被引：78

作者：

Au, Lewis ^{[1
,2
,3
]}

Fendler, Annika ^{[1
]}

Shepherd, Scott T. C. ^{[1
,2
,3
]}

Rzeniewicz, Karolina ^{[1
]}

Cerrone, Maddalena ^{[4
,5
]}

Byrne, Fiona ^{[1
]}

Carlyle, Eleanor ^{[2
,3
]}

Edmonds, Kim ^{[2
,3
]}

Del Rosario, Lyra ^{[2
,3
]}

Shon, John ^{[6
]}

Haynes, Winston A. ^{[6
]}

Ward, Barry ^{[1
]}

Shum, Ben ^{[1
,2
,3
]}

Gordon, William ^{[1
]}

Gerard, Camille L. ^{[1
,7
]}

Xie, Wenyi ^{[1
]}

Joharatnam-Hogan, Nalinie ^{[2
,3
]}

Young, Kate ^{[2
,3
]}

Pickering, Lisa ^{[2
,3
]}

Furness, Andrew J. S. ^{[2
,3
]}

Larkin, James ^{[2
,3
]}

Harvey, Ruth ^{[8
]}

Kassiotis, George ^{[9
]}

Gandhi, Sonia ^{[10
,11
]}

Swanton, Charles ^{[12
]}

Fribbens, Charlotte ^{[12
,13
,14
]}

Wilkinson, Katalin A. ^{[4
]}

Wilkinson, Robert J. ^{[4
,5
]}

Lau, David K. ^{[14
]}

Banerjee, Susana ^{[15
,16
]}

Starling, Naureen ^{[14
]}

Chau, Ian ^{[14
]}

Turajlic, Samra ^{[1
,2
,3
]}

机构：

[1] Francis Crick Inst, Canc Dynam Lab, London, England

[2] Royal Marsden NHS Fdn Trust, Skin Unit, London, England

[3] Royal Marsden NHS Fdn Trust, Renal Unit, London, England

[4] Francis Crick Inst, TB Lab, London, England

[5] Imperial Coll London, Dept Infect Dis, London, England

[6] Serimmune Inc, Goleta, CA USA

[7] Lausanne Univ Hosp CHUV, Precis Oncol Ctr, Lausanne, Switzerland

[8] Francis Crick Inst, Worldwide Influenza Ctr, London, England

[9] Francis Crick Inst, Retroviral Immunol Lab, London, England

[10] Francis Crick Inst, Neurodegenerat Biol Lab, London, England

[11] UCL Queen Sq Inst Neurol, Queen Sq, London, England

[12] Francis Crick Inst, Canc Evolut & Genome Instabil Lab, London, England

[13] Royal Marsden NHS Fdn Trust, Acute Oncol Serv, London, England

[14] Royal Marsden NHS Fdn Trust, Gastrointestinal & Lymphoma Unit, Sutton, Surrey, England

[15] Royal Marsden NHS Fdn Trust, Gynaecol Unit, London, England

[16] Inst Canc Res, London, England

来源：

NATURE MEDICINE | 2021年 / 27卷 / 08期

基金：

英国医学研究理事会; 英国惠康基金;

关键词：

RESPONSES; COVID-19; SAFETY;

D O I：

10.1038/s41591-021-01387-6

中图分类号：

Q5 [生物化学]; Q7 [分子生物学];

学科分类号：

071010 ; 081704 ;

摘要：

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.

引用

页码：1362 / +

页数：11

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