Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, NY.
American Society of Clinical Oncology, Alexandria, VA.
J Clin Oncol. 2024 May 10;42(14):1699-1721. doi: 10.1200/JCO.24.00032. Epub 2024 Mar 18.
To guide the vaccination of adults with solid tumors or hematologic malignancies.
A systematic literature review identified systematic reviews, randomized controlled trials (RCTs), and nonrandomized studies on the efficacy and safety of vaccines used by adults with cancer or their household contacts. This review builds on a 2013 guideline by the Infectious Disease Society of America. PubMed and the Cochrane Library were searched from January 1, 2013, to February 16, 2023. ASCO convened an Expert Panel to review the evidence and formulate recommendations.
A total of 102 publications were included in the systematic review: 24 systematic reviews, 14 RCTs, and 64 nonrandomized studies. The largest body of evidence addressed COVID-19 vaccines.
The goal of vaccination is to limit the severity of infection and prevent infection where feasible. Optimizing vaccination status should be considered a key element in the care of patients with cancer. This approach includes the documentation of vaccination status at the time of the first patient visit; timely provision of recommended vaccines; and appropriate revaccination after hematopoietic stem-cell transplantation, chimeric antigen receptor T-cell therapy, or B-cell-depleting therapy. Active interaction and coordination among healthcare providers, including primary care practitioners, pharmacists, and nursing team members, are needed. Vaccination of household contacts will enhance protection for patients with cancer. Some vaccination and revaccination plans for patients with cancer may be affected by the underlying immune status and the anticancer therapy received. As a result, vaccine strategies may differ from the vaccine recommendations for the general healthy adult population vaccine.Additional information is available at www.asco.org/supportive-care-guidelines.
指导患有实体瘤或血液恶性肿瘤的成年人进行疫苗接种。
通过系统文献回顾,确定了针对癌症患者或其家庭接触者使用的疫苗的疗效和安全性的系统评价、随机对照试验(RCT)和非随机研究。本综述是美国传染病学会 2013 年指南的基础上进行的。从 2013 年 1 月 1 日至 2023 年 2 月 16 日,在 PubMed 和 Cochrane Library 进行了检索。美国临床肿瘤学会召集了一个专家小组来审查证据并制定建议。
系统评价共纳入 102 篇文献:24 篇系统评价、14 项 RCT 和 64 项非随机研究。最大的证据体涉及 COVID-19 疫苗。
疫苗接种的目的是限制感染的严重程度,并在可行的情况下预防感染。优化疫苗接种状态应被视为癌症患者护理的关键要素。这种方法包括在首次就诊时记录疫苗接种状态;及时提供推荐的疫苗;以及在造血干细胞移植、嵌合抗原受体 T 细胞治疗或 B 细胞耗竭治疗后进行适当的复种。需要医疗保健提供者(包括初级保健医生、药剂师和护理团队成员)之间的积极互动和协调。对家庭接触者进行疫苗接种将增强对癌症患者的保护。一些癌症患者的疫苗接种和复种计划可能会受到潜在免疫状态和接受的抗癌治疗的影响。因此,疫苗策略可能与一般健康成年人群体的疫苗推荐不同。更多信息可在 www.asco.org/supportive-care-guidelines 上获得。