A retrospective analysis of patients with advanced lung cancer revealed that those vaccinated with an mRNA Covid-19 vaccine had better survival outcomes when taking immune checkpoint inhibitors, compared to unvaccinated patients.
The findings were presented earlier this month at the European Society for Medical Oncology (ESMO) 2024 meeting in Barcelona, Spain.
Out of 2,406 patients with stage III or IV non-small cell lung cancer (NSCLC), 57.2% of people who were vaccinated with Moderna or Pfizer/BioNTech’s Covid-19 jab within 100 days of starting treatment with an immune checkpoint inhibitor were still alive three years later, compared to 30.7% of patients who had not been recently vaccinated.
Checkpoint inhibitors like MSD’s Keytruda (pembrolizumab) and Bristol Myers Squibb’s Opdivo (nivolumab) have drastically changed the cancer treatment landscape. These drugs work by blocking proteins used by cancer cells to evade the immune system, enabling immune cells to better attack and destroy the cancer.
Adam Grippin, a radiation oncologist who led the retrospective study at the University of Texas MD Anderson Cancer Center, explained that researchers hypothesise that the mRNA vaccines may trigger an anti-tumour response, leading to increased expression of PD-L1 – a protein that allows tumour cells to evade immune cell attack. By increasing the expression of this protein, the vaccines could enhance the effectiveness of immune checkpoint therapies, which target PD-L1.
“We were really surprised by the magnitude of change that we were seeing in these patients, which suggests to us that these Covid-19 mRNA vaccines may be stronger immune agonists than some of the vaccines that we had evaluated preclinically,” said Grippin in an interview with Pharmaceutical Technology.
Researchers have been actively exploring drugs to be used alongside immune checkpoint inhibitors to enhance their effectiveness, such as targeted therapies, cancer vaccines, or agents that modify the tumour microenvironment. This is to overcome the issue of patients developing resistance to immune checkpoint inhibitors.
The researchers at MD Anderson plan to confirm these findings through prospective studies and determine the exact mechanism behind the observed effects. Grippin explained that if these findings are validated, Covid-19 mRNA vaccines could provide a significant benefit to a large population of cancer patients receiving immune checkpoint inhibitors, due to the wide availability of these vaccines.
“This could be a huge benefit to a large number of patients all around the world, because this is not a therapy that is confined to those within 100 miles of an academic medical centre. This is a therapy that is available for free at pharmacies around the world. It's proven to be safe, has been administered over 3.3 billion doses, so we feel very comfortable with it.”
Keytruda, a PD-1 checkpoint inhibitor, generated $25bn last year, as per MSD’s financials. This revenue flow is expected to continue growing with GlobalData predicting that the blockbuster will pull in $33.7bn in 2028, when key Keytruda patents are set to expire.
GlobalData is the parent company of Pharmaceutical Technology.
