|LETTER TO THE EDITOR
|Year : 2021 | Volume
| Issue : 4 | Page : 804-805
Need more evidence for establishing standard vaccination practices among patients with cancer
Sharmila Pimple, Gauravi Ashish Mishra
Department of Preventive Oncology, Centre for Cancer Epidemiology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
|Date of Submission||11-Nov-2021|
|Date of Decision||07-Dec-2021|
|Date of Acceptance||10-Dec-2021|
|Date of Web Publication||29-Dec-2021|
Department of Preventive Oncology, Centre for Cancer Epidemiology, Tata Memorial Centre (a grant-in-aid institution under the Department of Atomic Energy [DAE], Government of India), Homi Bhabha National Institute, Mumbai, Maharashtra
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Pimple S, Mishra GA. Need more evidence for establishing standard vaccination practices among patients with cancer. Cancer Res Stat Treat 2021;4:804-5
|How to cite this URL:|
Pimple S, Mishra GA. Need more evidence for establishing standard vaccination practices among patients with cancer. Cancer Res Stat Treat [serial online] 2021 [cited 2022 May 28];4:804-5. Available from: https://www.crstonline.com/text.asp?2021/4/4/804/334218
We read with interest the review article titled, “Vaccination practices, efficacy, and safety in adults with cancer: A narrative review,” which provided an overview of the commonly administered vaccines among patients with cancer. Patients with cancer, due to their immunocompromised state, are at greater risk of acquiring potentially life-threatening infections; however, the degree of risk varies based on the underlying malignancy and type of immunosuppressive treatments used. Significant advances in cancer treatment, including targeted therapies, have led to improved outcomes among patients with cancer, resulting in improved quality of life and survival. Thus, routine immunization against potential infectious agents and preventive care plays an important role in the overall healthcare of these patients.
Although preventive vaccination has been part of cancer management, very limited data exist on the true efficacy of vaccines in immunosuppressed patients with cancer. This is because the majority of these studies are not specifically designed or powered to identify differences in the risk of infection. Thus, the current guidelines and recommendations are primarily based on the scarce safety data and existing knowledge about the immune responses to various vaccines.
Vaccine response among patients with cancer may vary depending on the cancer type and therapy administered; hence, safety and efficacy data for patients with different cancer types and various chemotherapy regimens are required to elucidate and assess the impact and suitability of preventive vaccination under prevailing disease conditions. Adequately powered studies need to be designed to provide evidence of potential risks versus benefits of preventive vaccination among patients with cancer to demonstrate decrease in opportunistic or potentially life-threatening infections with improved survival outcomes, if any. A recently published meta-analysis reported significantly lower rates of lower respiratory tract infections, related hospitalization, and mortality among patients with cancer who received the influenza vaccine compared to those who did not.
Given the rapid advances and breakthroughs in cancer therapeutics during the past decade, longitudinal, prospective, multicountry clinical trials need to be performed to determine the efficacy of preventive vaccination, evaluate patterns of immunogenicity, and establish the effectiveness of preventive vaccination, including the need for long-term boosters. Likewise, there is also a need to study the interaction of preventive vaccines with specific immunotherapy regimens or adjuvants that help boost the immune response.
The timing of immunization and the relevance of vaccines in individual clinical circumstances are extremely crucial in determining how a vaccine will complement the treatment regimen. Individual patient assessment is therefore critical, and general guidelines for immunization may not be applicable.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Sarkar L, Goli VB, Menon N, Patil VM, Noronha V, Prabhash K. Vaccination practices, efficacy, and safety in adults with cancer: A narrative review. Cancer Res Stat Treat 2021;4:505-15. [Full text]
Ariza-Heredia EJ, Chemaly RF. Practical review of immunizations in adult patients with cancer. Hum Vaccin Immunother 2015;11:2606-14.
Ljungman P. Vaccination of immunocompromised patients. Clin Microbiol Infect 2012;18 Suppl 5:93-9.
Cheuk DK, Chiang AK, Lee TL, Chan GC, Ha SY. Vaccines for prophylaxis of viral infections in patients with hematological malignancies. Cochrane Database Syst Rev 2011;3:CD006505.