Bersanelli Melissa, Buti Sebastiano, De Giorgi Ugo, Di Maio Massimo, Giannarelli Diana, Banna Giuseppe Luigi
Oncologia Medica, Azienda Ospedaliero-Universitaria di Parma.
Oncologia Genito-Urinaria, IRST-IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola (FC).
Recenti Prog Med. 2018 Nov;109(11):540-546. doi: 10.1701/3031.30291.
Influenza vaccination is recommended by national and international guidelines in cancer patients, due to the likely compromised immune status and the risk of major complications from the infection. Nevertheless, the infectious morbidity and mortality of cancer patients treated with anti-PD-1/PD-L1 immune checkpoint inhibitors have not been explored. Currently, no solid data support the efficacy and safety of influenza vaccination in this subgroup. The few available retrospective studies suggest a low efficacy of the vaccine, posing legitimate doubts about its safety. On the other hand, influenza vaccination does not seem to compromise the efficacy of immunotherapy. In conclusion, current data are limited and do not allow a unique recommendation about influenza vaccination during cancer immunotherapy, suggesting a conservative attitude and a personalized assessment of risks and benefits pending prospective data.
由于癌症患者的免疫状态可能受损以及感染引发重大并发症的风险，国家和国际指南均建议对其进行流感疫苗接种。然而，接受抗PD-1/PD-L1免疫检查点抑制剂治疗的癌症患者的感染发病率和死亡率尚未得到研究。目前，没有确凿数据支持该亚组患者接种流感疫苗的有效性和安全性。少数现有的回顾性研究表明疫苗效力较低，这对其安全性提出了合理质疑。另一方面，流感疫苗接种似乎不会影响免疫治疗的疗效。总之，目前的数据有限，无法就癌症免疫治疗期间的流感疫苗接种给出统一建议，这表明在获得前瞻性数据之前应持保守态度并对风险和益处进行个性化评估。
