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Abstract Background COVID‐19 incidence is high in patients with cancer. The fatality rate was high for the Delta variant, necessitating infection prevention by vaccination. This study evaluated the safety of a SARS‐CoV‐2 vaccine in patients with advanced lung cancer receiving anticancer therapy. Methods We prospectively enrolled patients receiving anticancer drugs for advanced lung cancer and planning SARS‐CoV‐2 vaccination. Early side effects within 7 days of vaccination were evaluated using patient‐reported outcome (PRO) surveys. Chi‐square test and multivariate logistic regression analyses were used. Results Post‐vaccination PROs were collected from 406 patients (252 were males). The mean age was 72 years. Treatment at the time of initial vaccination included chemotherapy, immune checkpoint inhibitors (ICI), a combination of chemotherapy and ICI, targeted therapy including tyrosine kinase inhibitors, and others in 115, 93, 45, 147, and six cases, respectively. The vaccines administered were BNT162b2 and mRNA273 in 361 and three cases, respectively and unknown in 42 cases. A total of 16.1% of patients developed fever (38°C) after the second mRNA vaccination (95% confidence interval: 12.6%–20.1%). This rate is comparable to data previously reported in 120 patients and slightly higher than that of healthy participants of the BNT162b2 study. Patients receiving treatment with cytotoxic anticancer agents were more likely to have high fever. Multivariate analysis showed no correlation between fever frequency and patient background. No serious initial adverse events due to vaccination were observed. Conclusions Anti‐SARS‐CoV‐2 mRNA vaccination is safe; however, post‐vaccination fever is more common in patients undergoing lung cancer treatment than in healthy individuals.

Abstract Background Since 2020, severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) has become prevalent worldwide. In severe cases, the case fatality rate is high, and vaccine prevention is important. This study evaluated the safety of receiving SARS‐CoV‐2 vaccine in patients with advanced lung cancer receiving anticancer therapy. Methods We prospectively enrolled patients receiving anticancer drugs for advanced lung cancer who planned to receive SARS‐CoV‐2 vaccination. Early adverse events within 7 days of vaccine injection were evaluated using patient‐reported surveys. The chi‐square test and multivariate logistic regression analyses were used. Results Among 120 patients receiving lung cancer treatment, 73 were men; the mean age of the patients was 73.5 years. The treatments received for lung cancer at the time of the first vaccine injection were chemotherapy, ICIs, combined chemotherapy and ICIs, and targeted therapies, including tyrosine kinase inhibitors, in 30, 28, 17, and 45 patients, respectively. All patients received SARS‐CoV‐2 messenger RNA (mRNA) vaccine. After the second mRNA vaccine dose, 15.4% of patients had fever of 38°C (95% confidence interval: 9.34%–23.2%); this rate was slightly higher than that for healthy participants at the time of the BNT162b2 trial. Patients treated with cytotoxic anticancer drugs tended to have high fever. In the multivariate analyses, male sex was associated with higher fever frequencies. However, there were no serious early adverse events due to vaccination. Conclusions Anti‐SARS‐CoV‐2 mRNA vaccination tends to be safe, but fever following vaccination tends to be more common among patients undergoing lung cancer treatment than among healthy individuals.

Abstract Primary salivary gland‐type tumors of the lung are rare, accounting for

Abstract Epidermal growth factor receptor (EGFR)‐tyrosine kinase inhibitors (TKIs) are key drugs in the treatment of non‐small cell lung cancer (NSCLC) patients with EGFR mutations; however, first‐generation EGFR‐TKIs, such as gefitinib and erlotinib, are not effective in patients with uncommon EGFR mutations. In contrast, efficacy of afatinib has been reported in some types of uncommon EGFR mutation such as G710X, L861Q. The effect of afatinib in NSCLC patients with the EGFR K860I mutation has been shown in vitro, but its clinical efficacy has not been demonstrated. Here, we report the experience of afatinib administration in an NSCLC patient with an EGFR K860I mutation. A 69‐year‐old woman presented with right hemiplegia and dysarthria. Multiple brain and lung tumors were observed. She underwent craniotomy and was diagnosed with lung adenocarcinoma. After stereotactic brain radiation therapy, cisplatin, pemetrexed, and bevacizumab combination therapy was initiated. Unfortunately, she was unable to continue chemotherapy as she had an intestinal perforation after two cycles. After five months, recurrence of multiple brain metastases and an increase in primary lung cancer were confirmed. Next‐generation sequencing (NGS) was performed in a clinical trial, and an EGFR K860I mutation was detected in her tumor. Afatinib was administered and the primary lung tumor shrank, but multiple brain metastases were exacerbated. After irradiation of the brain, afatinib administration was continued. In conclusion, afatinib may show an effect in NSCLC patients with the EGFR K860I mutation, but its efficacy is limited.