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. 2026 Apr;48(4):1104-1112.
doi: 10.1002/hed.70104. Epub 2025 Nov 19.

Fully COVID-19 Vaccinated Status Enhanced the Efficacy of Immune Checkpoint Inhibitors in Patients With Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma

Chien-Chung Wang  1   2 , Chih-Chun Wang  1   2 , Chuan-Chien Yang  1   2 , Tzer-Zen Hwang  1   2 , Ching-Feng Lien  1   2 , Yu-Chen Shih  2   3 , Shyh-An Yeh  2   4 , Meng-Che Hsieh  2   5
Affiliations

Fully COVID-19 Vaccinated Status Enhanced the Efficacy of Immune Checkpoint Inhibitors in Patients With Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma

Chien-Chung Wang et al. Head Neck. 2026 Apr.

Abstract

Background: Little is known regarding the interaction between vaccination and immunotherapy in cancer patients. Herein, we conducted a retrospective study to evaluate the impact of coronavirus disease 2019 (COVID-19) vaccinated status on survival in patients with recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC) treated with immune checkpoint inhibitors (ICI).

Methods: Patients who were treated with ICI for their R/M HNSCC were reviewed retrospectively. Patients who received at least one shot of the vaccine against COVID-19 were recruited into our study. Patients were stratified into fully vaccinated (FV) and partially vaccinated (PV) according to their vaccination status. Kaplan-Meier curves were estimated for progression-free survival (PFS) and overall survival (OS).

Results: A total of 127 patients were enrolled in our study for oncologic outcomes evaluation, including 70 FV and 57 PV. For the total population, the median PFS was 4.6 months and OS was 23.7 months. After stratifying according to COVID-19 vaccination status, the median PFS was 6.2 months in FV and 3.1 months in PV (p = 0.010). The median OS was 32.5 months in FV and 10.3 months in PV (p < 0.001). After the last dose of vaccination, the median neutrophil-lymphocyte ratio and platelet-lymphocyte ratio were significantly lower in FV than in PV (p < 0.001). No new safety issues were found in our patient cohort and were insignificant between the FV and PV groups.

Conclusions: R/M HNSCC patients with FV had significantly lower NLR and PLR, and had better survival when treated with ICI without increasing treatment toxicity.

Keywords: COVID‐19; immune checkpoint inhibitors; recurrent or metastatic head and neck squamous cell carcinoma; survival; vaccinated status.

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References

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