Patients with cancer have a higher risk of severe coronavirus disease (COVID-19) and associated mortality than the general population. Owing to this increased risk, patients with cancer have been prioritized for COVID-19 vaccination globally, for both primary and booster vaccinations. However, given that these patients were not included in the pivotal clinical trials, considerable uncertainty remains regarding vaccine efficacy, and the extent of humoral and cellular immune responses in these patients, as well as the risks of vaccine-related adverse events. In this Review, we summarize the current knowledge generated in studies conducted since COVID-19 vaccines first became available. We also highlight critical points that might affect vaccine efficacy in patients with cancer in the future. Vaccination against COVID-19 confers robust protection from severe disease. However, the extent to which this applies to patients with cancer remains uncertain given that these patients were excluded from most of the pivotal studies. In this Review, the authors provide an overview of the efficacy and immunogenicity of COVID-19 vaccines in patients with cancer, and discuss alternatives to vaccination for those who might be unable to develop a proficient immune response following vaccination. Key points Vaccination against COVID-19 administered according to current prime–boost concepts is both safe and clinically effective in patients with cancer. To date, no reliable correlate of protection that allows the definite deduction of clinical efficacy from immune responses has been established, either in patients with cancer or in the general population. Patient-associated factors such as advanced age, haematological malignancy and/or treatment-associated factors such as B cell depletion might all lead to less proficient immune responses following vaccination. Future research will determine the necessity of further booster regimens as well as therapeutic options for those who do not benefit from active COVID-19 vaccination.
【저자키워드】 Infectious diseases, RNA vaccines, Cancer, Disease prevention,