NCCN updates guidance on COVID-19 prevention for patients with cancer
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National Comprehensive Cancer Network has issued updated guidance on COVID-19 vaccination and pre-exposure prophylaxis for patients with cancer.
The revised recommendations state that these individuals should receive full vaccination, “including third doses and/or any approved boosters,” with a strong preference for mRNA vaccines, according to an NCCN press release. They also include information about preventive use of human monoclonal antibodies amid a rapid rise in infection rates.
“We have new agents to prevent and treat COVID-19 that will benefit patients with cancer,” Brahm Segal, MD, chief of infectious diseases and professor of oncology at Roswell Park Comprehensive Cancer Center and co-leader of the NCCN Advisory Committee on COVID-19 Vaccination and Pre-exposure Prophylaxis, said in an NCCN press release. “An important challenge on a national level is to ensure drug availability to patients with cancer and others at high risk for COVID-19.”
Last month, the FDA approved an emergency use authorization for the long-acting monoclonal antibody combination of tixagevimab plus cilgavimab (Evusheld, AstraZeneca) to prevent symptomatic COVID-19 among adults and children aged 12 years and older with moderate to severely compromised immune systems that may not be responsive to vaccination.
When supplies of tixagevimab plus cilgavimab are limited, it would be reasonable to prioritize patients with blood cancer for the combination over those with solid tumors, according to the committee.
The committee also:
- recommended vaccination delays of at least 3 months after hematopoietic cell transplantation or engineered cellular therapy, such as chimeric antigen receptor T-cell therapy, to ensure maximum vaccine efficacy;
- endorsed full vaccination for caregivers, household members and close contacts of patients with cancer, as well as the general public;
- expressed strong support of full vaccination mandates for health care workers; and
- supported recommendations from the CDC, American Society of Transplantation and Cellular Therapy and ASH that vaccinated patients who complete stem cell transplantation or engineered cellular therapy receive another vaccination series beginning 3 months after treatment.
“The medical and scientific community’s response to the COVID-19 crisis continues to be extremely encouraging, even in the face of setbacks like new variants and surging infection rates,” Robert W. Carlson, MD, CEO of NCCN, said in the press release. “Rapid research, thoughtful analyses, and tireless care delivery is allowing us to save so many more people than we could have a year ago. We hope by sharing this simplified guidance highlighting the latest research and approvals, we can help make sure the very latest in evidence-based care reaches as many patients and providers as possible.”
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