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Old 12-27-2020, 10:09 AM   #1
Nguyen
Senior Member
 
Join Date: Nov 2005
Posts: 503
Covid vaccines and cancer patients

Very little information at the moment, I'll keep update this as I see more.

Nguyen


https://ascopost.com/issues/december...id-19-vaccine/

https://www.asco.org/asco-coronaviru...atients-cancer

https://www.esmo.org/covid-19-and-ca...19-vaccination

What is the ability of cancer patients to mount an immune response following vaccination?

Data on humoral and cellular immune response to antiviral vaccination in cancer patients are scarce, and mostly address the issue of influenza vaccination [1,2]. Observational clinical studies indicate that lower mortality and morbidity rates from influenza are observed in cancer patients receiving influenza vaccination [II] [3], suggesting an efficient immune response.

In lung and breast cancer patients, the humoral immune response to vaccination appears adequate, although not all patients were receiving chemotherapy [IV] [4,5]. In a study of patients with various solid tumours, the response to vaccination was better than in patients with lymphoma [IV] [6].

In patients receiving chemotherapy, seroconversion and seroprotection rates are expected to be lower than in the general population [IV] [7], but not in patients receiving single-agent immune checkpoint inhibitors targeting programmed cell death protein 1 (PD-1)/programmed death-ligand 1 (PD-L1) [IV] [8].

In patients receiving chemotherapy, multiple doses of vaccine might help to reach adequate seroconversion and seroprotective rates. As an illustration, in a non-randomised Phase II study on 65 patients with solid tumours receiving chemotherapy (+/- molecular targeted agents) during the 2009 influenza season, 5% of patients had vaccine strain titres of specific haemagglutination inhibition antibodies that were ≥1:40 at baseline. After one and two doses of AS03A-adjuvanted H1N1v vaccine, seroprotection rates (i.e. the proportion of participants with antibody titres ≥1:40) were 48% and 73%, respectively, and seroconversion rates were 44% and 73%, respectively [III] [9].

Whenever possible, the administration of the vaccine should be performed before initiation of chemotherapy [V] [2]. In patients who have already initiated chemotherapy, the existing data do not support a specific timing of administration with respect to chemotherapy infusions [III] [2, 9].
In order to generate protective immunity following vaccination, intact host immunity is needed, particularly with respect to antigen presentation, B- and T-cell activation. In this context, vaccination may be less effective in patients receiving anti–B-cell antibodies or intensive chemotherapy (e. g. induction or consolidation chemotherapy for acute leukaemia) because the antibody response may be low, due to B-cell depletion, though the role and potential protective effect of T-cell immunity has not been studied extensively [V] [2].

The level of evidence is weak, due to the small number of studies and their methodology; placebo-controlled randomised controlled trials of antiviral vaccination among adults with cancer being often considered ethically questionable [V] [2].
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