Sex: M
Vaccine: COVID19
Symptoms: Decreased appetite, Positron emission tomogram, Therapeutic response unexpected, Weight, Weight decreased
Clinical narrative: After COVID-19 booster vaccine, he became anorexic, lost 50 lbs over 8 weeks (267 to 211 lb); lost 50 lbs over 8 weeks (267 to 211 lb); PET CT showed complete resolution of his lung nodules and adenopathy; This is a literature report for the following literature source(s): A 58-year-old male patient received BNT162b2 (COVID-19 VACCINE NOS MANUFACTURER UNKNOWN), as dose number unknown (booster), single for covid-19 immunisation. The patient's relevant medical history included: "stage IV clear cell renal carcinoma (lung nodules, mediastinal nodes)" (ongoing); "low carbohydrate diets" (unspecified if ongoing). The patient's concomitant medications were not reported. Past drug history included: Sunitinib for stage IV clear cell renal carcinoma (lung nodules, mediastinal nodes), reaction(s): "he progressed on Sunitinib"; Nivolumab for stage IV clear cell renal carcinoma (lung nodules, mediastinal nodes), reaction(s): "hypophysitis"; Nivolumab for stage IV clear cell renal carcinoma (lung nodules, mediastinal nodes), reaction(s): "diarrhea"; Nivolumab for stage IV clear cell renal carcinoma (lung nodules, mediastinal nodes), reaction(s): "severe jaw pain". Vaccination history included: Covid-19 vaccine (Primary Immunization series complete;  unknown manufacturer), for COVID-19 immunisation. The following information was reported: DECREASED APPETITE (medically significant), outcome "unknown", described as "After COVID-19 booster vaccine, he became anorexic, lost 50 lbs over 8 weeks (267 to 211 lb)"; WEIGHT DECREASED (medically significant), outcome "unknown", described as "lost 50 lbs over 8 weeks (267 to 211 lb)"; THERAPEUTIC RESPONSE UNEXPECTED (non-serious), outcome "unknown", described as "PET CT showed complete resolution of his lung nodules and adenopathy". The patient underwent the following laboratory tests and procedures: Positron emission tomogram: showed complete resolution of his lung nodules and, notes: adenopathy; Weight: lost 50, notes: over 8 weeks (267 to 211 lb).  Clinical course: A 58-year-old male diagnosed with stage IV clear cell renal carcinoma (lung nodules, mediastinal nodes). After 5 years he progressed on Sunitinib and began Nivolumab. His cancer stabilized but hypophysitis, diarrhea, severe jaw pain ended his treatment. After COVID-19 booster vaccine, he became anorexic, lost 50 lbs over 8 weeks (267 to 211 lb). Relapse was suspected but PET CT showed complete resolution of his lung nodules and adenopathy. Asymptomatic and in remission over 9 months post vaccine. Conclusions: Effects of SARS-CoV-2 (COVID-19) on cancers remain unknown. Few case reports of cancer remissions after infections are emerging. These are two cases of renal cell cancers in complete remission after COVID-19 vaccination while on immunotherapy. Both followed low glycemic diets. Third case was a complete remission of biliary cancer after an acute COVID-19 infection. Proposed anti-cancer mechanisms - pathogen specific T cell action, anti-inflammatory effects against COVID-19 infection, cross-reactivity against tumor antigens, natural killer cell activation. COVID-19 proteins have oncolytic properties - HIV related B cell apoptosis and Coxsackievirus A21 oncolytic effects on myeloma and CD138+ plasma cells via intercellular adhesion molecule interaction. COVID- 19's effects plus the anti PD-1/PD-L1 antibodies immune response may be synergistic and merits further research. Research Sponsor: None.; Sender's Comments: Based on the information available and plausible temporal association, the causal relationship between the reported events and suspect drug BNT162B2 cannot be excluded. However a contributory role of the underlying medical condition of Carcinoma cannot be excluded. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.