个性化mRNA疫苗是一种对于癌症患者具有希望的新的治疗选择。由于mRNA疫苗尚未获得一线疗法的批准，目前将疫苗应用于接受过可能具有免疫损害效果的前期治疗的个体身上。有必要解决前期治疗对mRNA疫苗结果的影响。因此，我们分析了237名肿瘤科门诊患者对BioNTech/Pfizer的抗SARS-CoV-2 mRNA疫苗的反应，这些患者涵盖了各种血液系统恶性肿瘤和实体肿瘤以及多种治疗方式。患者根据最后一次治疗和首次接种疫苗之间的时间间隔以及是否存在明显肿瘤进行分层，然后在第二次接种疫苗后的14天进行IgG滴度和T细胞反应的分析。不论最后一次治疗的时间点如何，我们的数据表明，与健康对照组相比，接受checkpoint抑制剂治疗的患者的疫苗反应是相当的。相反，经历过化疗或强的松治疗的患者，在最后一次系统性治疗后6个月之前不会产生免疫反应，而经历过化疗-免疫检查点抑制剂和酪氨酸激酶抑制剂治疗的患者需要12个月后才会产生免疫反应。基于这些，我们的数据支持mRNA疗法的时间安排是关键的，我们建议在系统性治疗患者接受mRNA疫苗之前至少需要等待6个月或12个月。©作者（或其雇主）2023年。在CC BY-NC许可下允许再使用。不允许商业再使用。由BMJ出版。

Personalized mRNA vaccines are promising new therapeutic options for patients with cancer. Because mRNA vaccines are not yet approved for first-line therapy, the vaccines are presently applied to individuals that received prior therapies that can have immunocompromising effects. There is a need to address how prior treatments impact mRNA vaccine outcomes.Therefore, we analyzed the response to BioNTech/Pfizer's anti-SARS-CoV-2 mRNA vaccine in 237 oncology outpatients, which cover a broad spectrum of hematologic malignancies and solid tumors and a variety of treatments. Patients were stratified by the time interval between the last treatment and first vaccination and by the presence or absence of florid tumors and IgG titers and T cell responses were analyzed 14 days after the second vaccination.Regardless of the last treatment time point, our data indicate that vaccination responses in patients with checkpoint inhibition were comparable to healthy controls. In contrast, patients after chemotherapy or cortisone therapy did not develop an immune response until 6 months after the last systemic therapy and patients after Cht-immune checkpoint inhibitor and tyrosine kinase inhibitor therapy only after 12 months.Accordingly, our data support that timing of mRNA-based therapy is critical and we suggest that at least a 6-months or 12-months waiting interval should be observed before mRNA vaccination in systemically treated patients.© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.