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- Title
Response to COVID-19 vaccination imaged by PD-L1 PET scanning.
- Authors
MacManus, Michael P; Akhurst, Tim; Lewin, Sharon R; Hegi-Johnson, Fiona
- Abstract
Background: During a phase 0 clinical trial of an investigational programmed cell death ligand-1 (PD-L1) PET tracer in patients with non-small cell lung cancer (NSCLC), three patients received booster doses of COVID-19 vaccines before PD-L1 imaging. Methods: Five patients underwent whole-body PET/CT imaging with a novel PD-L1 tracer, constructed by attaching 89Zr to the anti PD-L1 antibody durvalumab. Intramuscular (deltoid) booster doses of mRNA BNT162b2 COVID-19 mRNA vaccine were coincidentally given to three patients in the month before PD-L1 tracer injection. Results: Two recently-vaccinated patients, in remission of NSCLC and receiving non-immunosuppressive cancer therapies (immunotherapy and tyrosine kinase inhibitor respectively), showed increasing PD-L1 tracer uptake in ipsilateral axillary lymph nodes. No asymmetric nodal uptake was seen in a third recently-vaccinated patient who was receiving immunosuppressive chemotherapy, or in two patients not recently-vaccinated. Conclusion: Immune response to mRNA BNT162b2 vaccination may involve regulation by PD-L1 positive immune cells in local draining lymph nodes in immunocompetent patients. Trial Registration: This trial was registered with the Australian New Zealand Clinical Trials Registry. Registration number ACTRN12621000171819. Date of Trial Registration 8/2/2021. Date of enrolment of 1st patient 11/4/2021. URL of trial registry record: https://www.australianclinicaltrials.gov.au/anzctr/trial/ACTRN12621000171819. Key points: Question Does mRNA vaccination for COVID-19 cause changes in the immune system that involve the programmed cell death ligand-1 (PD-L1)? Pertinent Findings Two of two immunocompetent lung cancer patients in remission had markedly increasing uptake in draining axillary lymph nodes on PD-L1 positron emission tomography (PET) scans after recent COVID-19 vaccinations. A third, immunocompromised patient did not exhibit increasing nodal uptake. Implications for patient care Response to mRNA vaccination in immunocompetent patients appears to involve regulation by PD-L1 expressing immune cells. This knowledge could help in the design of better vaccines.
- Subjects
NEW Zealand; COVID-19 pandemic; POSITRON emission tomography; COVID-19 vaccines; NON-small-cell lung carcinoma; ASYMMETRIC dimethylarginine; APOPTOSIS
- Publication
European Journal of Hybrid Imaging, 2024, Vol 8, Issue 1, p1
- ISSN
2510-3636
- Publication type
Article
- DOI
10.1186/s41824-024-00196-7