Severe acute respiratory syndrome coronavirus 2 vaccination for patients with solid cancer: Review and point of view of a French oncology intergroup (GCO, TNCD, UNICANCER)

Abstract

\n The impacts of SARS-CoV-2 pandemic on cancer care are multiple, entailing a high risk of death from COVID-19 in cancer patients treated by chemotherapy. SARS-CoV-2 vaccines represent an opportunity to decrease the rate of severe COVID-19 cases in cancer patients and also to restore normal cancer care.\n Cancer patients to be targeted for vaccination are difficult to define due to the limited contribution of these patients in the phase III trials testing the different vaccines. It seems appropriate to vaccinate not only cancer patients with ongoing treatment or with a treatment having been completed less than 3 years ago, but also household and close contacts. High-risk cancer patients who are candidates for priority access to vaccination are those treated by chemotherapy. The very high-priority population includes patients with curative treatment and palliative first or second-line chemotherapy, as well as patients requiring surgery or radiotherapy involving a large volume of lung, lymph nodes and/or hematopoietic tissue.\n When possible, vaccination should be done before cancer treatment begins. SARS-CoV-2 vaccination can be performed during chemotherapy while avoiding periods of neutropenia and lymphopenia. For organisational reasons, vaccination should be performed in cancer care centers and may use mRNA vaccines or non-replicating adenoviral vaccines in non-immunocompromised patients under 65 years old.\n Considering the current state of knowledge, the benefit-risk ratio strongly favours SARS-CoV-2 vaccination of all cancer patients. In order to obtain more data concerning the safety and effectiveness of vaccines, it is necessary to implement cohorts of vaccinated cancer patients.\n