Table 3.
Summary of cases of irAEs after COVID-19 vaccination in patients treated with ICIs.
| No | Authors | Age/Sex | Medicine histories | ICIs | Time from last ICIs dose before onset (days) | Previous occurrences of irAE | Type of vaccine | Onset after which dose | Time to onset (days) | Symptoms | Laboratory examination | Diagnosis | Treatments | Prognosis |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | Au et al. [53] | 58/M | Colorectal cancer | Dostarlimab | 32 | Neurological- irAE, endocrine irAE | BioNTech | 1 | 5 | Myalgia, diarrhea, fever | CRP:125 mg/L; LDH:184 U/L; platelet: 68*109/L | Cytokine release syndrome | Antibiotics, methylprednisolone | Symptoms and biochemical parameters improved, resumed anti-PD-1 soon |
| 2 | Blaiseet al. [54] | 41/M | Melanoma, stage IIIB | Ipilimumab, nivolumab, 2 cycles | 3 | None | BioNTech | 1 | 10 | Muscle pain, limbs weakness, bulbar symptoms, dyspnea | CPK: 2647 IU/L | Necrotizing myopathy | Glucocorticoid | Clinical symptoms were almost complete after 2 months |
| 3 | Chong et al. [55] | 75/F | Lung cancer | Durvalumab | 7 | NA | Moderna | 1 | 3 | Hemoptysis | Platelet: 7*103/µL | Immune thrombocytopenia | Platelet transfusion, prednisolone | Continued oral prednisolone, and the ICP therapy was discontinued |
| 4 | El-Behaedi [56] | 74/F | Non-small cell lung cancer, stage III | Pembrolizumab, 13 cycles | 14 | None | BioNTech | 3 | 3 | Mild pruritic rash | NA | Epidermal necrosis with lichenoid reaction | Clobetasol cream | Rash completely cleared after several weeks, and resumed pembrolizumab therapy |
| 5 | Hussain et al. [57] | 62/F | Metastatic melanoma | Nivolumab, ipilimumab, 4 cycles | Nearly 82 | Raynaud disease, ICI-related myocarditis | BioNTech | 2 | 2 | Rash | NA | Erythrodermic | Methylprednisolone, famotidine | Improvement of rash within 2 weeks |
| 6 | Lasagna et al. [58] | 52/F | Lung cancer with metastasis | Pembrolizumab, 3 cycles | NA | NA | BioNTech | 1 | 10 | Diarrhea | AST: 147 IU/l; ALT: 299 IU/l; NLR: 2.29 | Hepatitis B virus infection, colitis | Entecavir, prednisone | Improved |
| 7 | Makiguchi et al. [59] | 65/F | Lung cancer with metastasis | Nivolumab, ipilimumab, 6 cycles | NA | NA | BioNTech | 2 | A few days | Fatigue, appetite loss, erythema | Blood glucose: 837 mg/dL; HbA1C, 9.4%; urine C-peptide: 2.9 μg/day; urinary ketone: 2+ | Diabetic ketoacidosis, T1DM | Insulin | Insulin treatment after discharge, and resumed nivolumab monotherapy |
| 8 | Mieczkow-ska et al. [60] | 65/M | Hepatocellular cancer | Nivolumab | 90 | NA | BioNTech | 1 | 7 | Worse pruritus, plaques increased | NA | Psoriasis | NA | Improved |
| 9 | Ohuchi et al. [61] | 45/M | Melanoma with metastasis | Nivolumab, cycles 12 | 10 | NA | BioNTech | 2 | 3 | Fatigue, dry mouth, polyuria, weight loss | Blood glucose: 655 mg/dL | Fulminant T1DM | NA | NA |
| 10 | Sato et al. [62] | 43/M | Melanoma | Nivolumab, cycles 12 | 9 | NA | mRNA | 2 | 2 | Thirst, polydipsia, polyuria, loss weight | Blood glucose: 655 mg/dL; HbA1C, 8.0%; 3-hydroxybutyric acid: 2813 µmol/L, acetoacetate: 1936 µmol/L | Fulminant T1DM, ketosis | Insulin | Insulin treatment after discharge |
| 11 | Sumi et al. [63] | 55/M | Non-small cell lung cancer, stage IV | Ipilimumab, nivolumab, | 11 | Adrenal failure | Moderna | 3 | 2 | High fever, disorientation | Ferritin: 1571.7 μg /L; CRP:17.22 mg/l; IL-6: 46.7 pg/mL; IL-10:15 pg/mL; IFN-γ:0.3 U/mL | Cytokine release syndrome | Steroid | Symptoms and biochemical parameters improved, maintenance dose of hydrocortisone |
| 12 | Takenaka et al. [64] | 25/M | Left parotid cancer | Nivolumab, | 21 | None | BioNTech | 2 | 2 | Fever, confused and agitated | CRP:9.04 mg/dl; D-dimer 4.5 μg/ml; anti-MOG:(+) | Autoimmune encephalitis | Steroid | Improved |
| 13 | Tripathy et al. [65] | 61/F | Lung cancer | Nivolumab | NA | Arthralgias | BioNTech | 1 | 14 | Left-sided retroauricular lymphadenopathy | White blood cell: 7300/mL, hemoglobin: 14.2 g/dL, platelet: 218000/mL | Tumor recurrence | Chemotherapy | Respond well to treatment |
ALT Alanine aminotransferase, AST Aspartate aminotransferase, COVID-19 coronavirus disease 2019, CPK creatine phosphokinase, CRP C-reactive protein, ICIs immune checkpoint inhibitor, IL interleukin, irAE immune-related adverse event, LDH lactate dehydrogenase, MOG myelin oligodendrocyte glycoprotein, NA not applicable, NLR Neutrophil/lymphocyte ratio, PD-1 programmed cell death protein-1, T1DM type 1 diabetes.