Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a rising threat for immunocompromised cancer patients. The reduced immune defense may be a result of the malignancy itself or a side effect of therapy. While many chemotherapies can severely diminish the effect of vaccines against SARS-CoV-2, the effect of radioligand therapy has not yet been studied so far.Methods: In our database, 64 patient records of patients with metastatic castration-resistant prostate cancer that were treated with PSMA-directed radioligand therapy (PRLT) were randomly selected and checked for specific information (vaccination status, past corona virus disease 2019 (COVID-19) infections, the period between PRLT and vaccination, and antibody titers). A total of 30 patient records had sufficient information to examine the interference between PRLT and the vaccination against SARS-CoV-2.Results: In the analyzed cohort, 96.7% of the patients achieved seroconversion after receiving—on average—the third (booster) vaccination against SARS-CoV-2 and two PRLT cycles with average administered activities of 16.1 ± 7.2 GBq (435.1 ± 194.6 mCi) of lutetium-177 and 13.7 ± 6.6 MBq (0.37 ± 0.18 mCi) of actinium-225 (as part of ‘TANDEM therapies’) per patient.Conclusions: In the reviewed population, neither the initial response nor the maintenance of a positive immune response against the SARS-CoV-2 virus was undesirably affected by PRLT. The seroconversion rate and the absolute immune titers (in many cases >25,000 BAU/mL) are comparable to the normal population. This result implies the clinically important conclusion that neither an initial nor a booster vaccination against COVID-19 must be postponed if a PRLT is planned (and vice versa).
背景：严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）对免疫功能受损的癌症患者构成日益严重的威胁。免疫功能下降可能是恶性肿瘤本身或治疗副作用所致。虽然许多化疗会严重削弱针对SARS-CoV-2的疫苗效果，但放射性配体疗法的影响迄今尚未得到研究。 方法：从本数据库中随机选取64例接受前列腺特异性膜抗原导向放射性配体疗法（PRLT）治疗的转移性去势抵抗性前列腺癌患者病历，核查其特定信息（疫苗接种状态、既往新型冠状病毒肺炎感染史、PRLT与疫苗接种间隔时间及抗体滴度）。其中30份病历具有充分信息可用于分析PRLT与SARS-CoV-2疫苗接种的相互影响。 结果：在分析队列中，96.7%的患者在接受平均第三次（加强）SARS-CoV-2疫苗接种及两个PRLT周期后实现血清转化。每位患者平均接受镥-177活度为16.1±7.2 GBq（435.1±194.6 mCi）及锕-225活度为13.7±6.6 MBq（0.37±0.18 mCi）（作为"TANDEM疗法"组成部分）。 结论：在观察人群中，PRLT未对针对SARS-CoV-2病毒的初始免疫应答及阳性免疫应答的维持产生不良影响。血清转化率及绝对免疫滴度（多数病例>25,000 BAU/mL）与正常人群相当。这一结果提示具有重要临床意义的结论：若计划进行PRLT治疗，无需推迟初始或加强COVID-19疫苗接种（反之亦然）。
肿瘤(癌症)患者之家