tetano
Editor, Senior Moderator
Nat Med
. 2021 May 26.
doi: 10.1038/s41591-021-01387-6. Online ahead of print.
Cytokine release syndrome in a patient with colorectal cancer after vaccination with BNT162b2
Lewis Au[SUP] #[/SUP][SUP] 1 2 [/SUP], Annika Fendler[SUP] #[/SUP][SUP] 1 [/SUP], Scott T C Shepherd[SUP] 1 2 [/SUP], Karolina Rzeniewicz[SUP] 1 [/SUP], Maddalena Cerrone[SUP] 3 4 [/SUP], Fiona Byrne[SUP] 1 [/SUP], Eleanor Carlyle[SUP] 2 [/SUP], Kim Edmonds[SUP] 2 [/SUP], Lyra Del Rosario[SUP] 2 [/SUP], John Shon[SUP] 5 [/SUP], Winston A Haynes[SUP] 5 [/SUP], Barry Ward[SUP] 1 [/SUP], Ben Shum[SUP] 1 2 [/SUP], William Gordon[SUP] 1 [/SUP], Camille L Gerard[SUP] 1 6 [/SUP], Wenyi Xie[SUP] 1 [/SUP], Nalinie Joharatnam-Hogan[SUP] 2 [/SUP], Kate Young[SUP] 2 [/SUP], Lisa Pickering[SUP] 2 [/SUP], Andrew J S Furness[SUP] 2 [/SUP], James Larkin[SUP] 2 [/SUP], Ruth Harvey[SUP] 7 [/SUP], George Kassiotis[SUP] 8 [/SUP], Sonia Gandhi[SUP] 9 10 [/SUP], Crick COVID-19 Consortium; Charles Swanton[SUP] 11 [/SUP], Charlotte Fribbens[SUP] 12 13 [/SUP], Katalin A Wilkinson[SUP] 3 [/SUP], Robert J Wilkinson[SUP] 3 4 [/SUP], David K Lau[SUP] 13 [/SUP], Susana Banerjee[SUP] 14 [/SUP], Naureen Starling[SUP] 13 [/SUP], Ian Chau[SUP] 13 [/SUP], CAPTURE Consortium; Samra Turajlic[SUP] 15 16 [/SUP]
Collaborators, Affiliations
Abstract
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-γ/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.
. 2021 May 26.
doi: 10.1038/s41591-021-01387-6. Online ahead of print.
Cytokine release syndrome in a patient with colorectal cancer after vaccination with BNT162b2
Lewis Au[SUP] #[/SUP][SUP] 1 2 [/SUP], Annika Fendler[SUP] #[/SUP][SUP] 1 [/SUP], Scott T C Shepherd[SUP] 1 2 [/SUP], Karolina Rzeniewicz[SUP] 1 [/SUP], Maddalena Cerrone[SUP] 3 4 [/SUP], Fiona Byrne[SUP] 1 [/SUP], Eleanor Carlyle[SUP] 2 [/SUP], Kim Edmonds[SUP] 2 [/SUP], Lyra Del Rosario[SUP] 2 [/SUP], John Shon[SUP] 5 [/SUP], Winston A Haynes[SUP] 5 [/SUP], Barry Ward[SUP] 1 [/SUP], Ben Shum[SUP] 1 2 [/SUP], William Gordon[SUP] 1 [/SUP], Camille L Gerard[SUP] 1 6 [/SUP], Wenyi Xie[SUP] 1 [/SUP], Nalinie Joharatnam-Hogan[SUP] 2 [/SUP], Kate Young[SUP] 2 [/SUP], Lisa Pickering[SUP] 2 [/SUP], Andrew J S Furness[SUP] 2 [/SUP], James Larkin[SUP] 2 [/SUP], Ruth Harvey[SUP] 7 [/SUP], George Kassiotis[SUP] 8 [/SUP], Sonia Gandhi[SUP] 9 10 [/SUP], Crick COVID-19 Consortium; Charles Swanton[SUP] 11 [/SUP], Charlotte Fribbens[SUP] 12 13 [/SUP], Katalin A Wilkinson[SUP] 3 [/SUP], Robert J Wilkinson[SUP] 3 4 [/SUP], David K Lau[SUP] 13 [/SUP], Susana Banerjee[SUP] 14 [/SUP], Naureen Starling[SUP] 13 [/SUP], Ian Chau[SUP] 13 [/SUP], CAPTURE Consortium; Samra Turajlic[SUP] 15 16 [/SUP]
Collaborators, Affiliations
- PMID: 34040262
- DOI: 10.1038/s41591-021-01387-6
Abstract
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-γ/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.