GÉTICA 2021

3 [ F I T C á n c e r - 7 ] With cytotoxic chemotherapy CANCER – VACCINES- COVID-19 Considerations for patients: treated with cytotoxic chemotherapy Patients with acute lymphoblastic leukemia , in which the immune system is directly impacted by disease as well as treatment: - Can still generate immune responses after vaccination, ranging from 10-27% of patients immunized with hepatitis B and meningococcal subunit vaccines and 100% immunized with diphtheria and tetanus toxoid vaccines. Patients with hematologic malignancies responded to one dose of influenza vaccine in 10-42% and its higher in solid tumors, at least 78% in patients with lung cancer and 81% with breast cancer. Mariano Provencio Servicio de Oncología Médica. Hospital Universitario Puerta de Hierro Majadahonda. Majadahonda, Madrid Precision medicine strategy Covid-19 and cancer With cytotoxic chemotherapy CANCER – VACCINES- COVID-19 Considerations for patients: treated with cytotoxic chemotherapy Lower responses compared with healthy controls Titers can be helpful to assess need for revaccination With targeted therapy CANCER – VACCINES- COVID-19 Considerations for patients: treated with targeted therapy: such as erlotinib, sunitinib, and imatinib or monoclonal antibodies such as trastuzumab Targeted therapy should not directly cause immunosuppression but may have unintended inhibitory effects on antigen presenting cell function, T cell activation and B cell signaling (Kersh AE. J Clin Pharmacol 2017; de Lavaillade H. Blood 2013). With cytotoxic chemotherapy CANCER – VACCINES- COVID-19 Considerations for patients: treated with cytotoxic chemotherapy Meta-analysis of trials on vaccination against influenza in immunocompromised patients Reduction symptomatic disease With targeted therapy CANCER – VACCINES- COVID-19 Considerations for patients: treated with targeted therapy: such as erlotinib, sunitinib, and imatinib or monoclonal antibodies such as trastuzumab With targeted therapy CANCER – VACCINES- COVID-19 Considerations for patients: treated with targeted therapy: such as erlotinib, sunitinib, and imatinib or monoclonal antibodies such as trastuzumab No difference in seroprotection against influenza in patients treated with trastuzumab