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  4. Avoiding biases when estimating effects of COVID-19 vaccination during immune checkpoint inhibitor therapy
 
preprint

Avoiding biases when estimating effects of COVID-19 vaccination during immune checkpoint inhibitor therapy

Dumas, Élise  
•
Gougis, Paul
•
Gasparollo, Lorenzo  
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November 4, 2025

SARS-CoV-2 mRNA vaccination (COVID-19 vaccination) within 100 days of immune checkpoint inhibitor (ICI) treatment was reported to improve survival and prevent disease progression in patients with non-small cell lung cancer (NSCLC) and metastatic melanoma (Grippin et al., Nature, 2025). However, the clinical evidence, derived from real-world observational data, suffers from methodological limitations. Specifically, the vaccinated and unvaccinated groups differed in subtle ways due to the timing of vaccination, the beginning of follow-up, and the definition of eligibility. These key limitations can be overcome by carefully conducting a target trial emulation analysis. Using the original data from Grippin et al., we emulated a target trial to estimate the causal effect of COVID-19 vaccination within 100 days of ICI initiation on overall survival and progression-free survival in patients with NSCLC and metastatic melanoma. In contrast to the original analysis, we found no evidence that COVID-19 vaccination improves survival outcomes in these populations.

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Name

10.1101_2025.11.03.25339367.pdf

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Main Document

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Accepted version

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openaccess

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CC BY-NC

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262.31 KB

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Adobe PDF

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76b241119d74c5183d5ff5f50a4ef529

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