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1. Bratislava Statement: consensus recommendations for improving pancreatic cancer care

Author

Pamela Minicozzi, Alfredo Carrato, Núria Malats, Francesco Sclafani, Thomas Brunner, Joan Prades, Antonella Cardone, Cristina Coll-Ortega, Samuel De Luze, Pascal Garel, Maria E Goossens, Roberto Grilli, Meggan Harris, Marleen Louagie, Stefano Partelli, Silvia Pastorekova, Marius Petrulionis, Bozena Smolkova, and Josep M Borras

Subjects
Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Pancreatic cancer is one of the most lethal tumours, and it is the fourth cause of cancer death in Europe. Despite its important public health impact, no effective treatments exist, nor are there high-visibility research efforts to improve care. This alarming situation is emblematic of a larger group of cancer diseases, known as neglected cancers. To address the impact of these diseases, the European Commission-supported Innovative Partnership for Action Against Cancer launched a multi-stakeholder initiative to determine key steps that healthcare systems can rapidly implement to improve their response. A working group comprising 20 representatives from European medical societies, patient associations, cancer plan organisations and other relevant European healthcare stakeholders was organised. A consensus process based on the results of different studies, discussion of research outcomes, and development and endorsement of draft statements resulted in 22 consensus recommendations (the Bratislava Statement). The statement argues that substantial improvements can be achieved in patient outcomes by centralising pancreatic cancer care around state-of-the-art reference centres, staffed by expert multidisciplinary teams capable of providing high-quality care. This organisational model requires a specific care framework encompassing primary, palliative and survivorship care, and a policy environment prioritising the use of quality criteria and performance assessments as well as research investments dedicated to prevention, risk prediction, early detection and diagnosis. In order to address the challenges posed by neglected cancers in general and pancreatic cancer in particular, a specific control strategy tailored to this reality is required.

Published
2020
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2. REDUCED HUMORAL IMMUNE RESPONSE AFTER BNT162B2 COVID-19 MRNA VACCINATION IN CANCER PATIENTS UNDER ANTI-NEOPLASTIC TREATMENT

Author

Kristof Y. Neven, S. Vande Kerckhove, Laure-Anne Teuwen, Manon T. Huizing, Ella Roelant, P. van Dam, Pieter Pannus, S. De Keersmaecker, I. Van der Massen, Marc Peeters, Isabelle Desombere, Bart Peeters, Timon Vandamme, Kevin K. Ariën, Y. Debie, Greetje Vanhoutte, Sébastien Anguille, Maria E Goossens, L. Verbruggen, M. Van Den Bulcke, Geert A. Martens, and S. Raats

Subjects
safety, Cancer Research, medicine.medical_specialty, COVID-19 Vaccines, medicine.medical_treatment, Antineoplastic Agents, Hematopoietic stem cell transplantation, Booster dose, Gastroenterology, Internal medicine, Neoplasms, medicine, Humans, cancer, Prospective Studies, RNA, Messenger, Adverse effect, BNT162 Vaccine, Original Research, Chemotherapy, anti-RBD IgG antibody response, business.industry, SARS-CoV-2, Vaccination, Antibody titer, Cancer, COVID-19, medicine.disease, Immunity, Humoral, BNT162b2 COVID-19 vaccination, Oncology, Rituximab, Human medicine, business, Anti-neoplastic treatment, medicine.drug
Abstract

Background: Cancer patients are at a higher risk of developing severe coronavirus disease 2019 (COVID-19). However, the safety and efficacy of COVID-19 vaccination in cancer patients undergoing treatment remain unclear. Patients and methods: In this interventional prospective multicohort study, priming and booster doses of the BNT162b2 COVID-19 vaccine were administered 21 days apart to solid tumor patients receiving chemotherapy, immunotherapy, targeted or hormonal therapy, and patients with a hematologic malignancy receiving rituximab or after allogeneic hematopoietic stem cell transplantation. Vaccine safety and efficacy (until 3 months post-booster) were assessed. Anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) receptor-binding domain (RBD) antibody levels were followed over time (until 28 days after the booster) and in vitro SARS-CoV-2 50% neutralization titers (NT50) toward the wild-type Wuhan strain were analyzed 28 days after the booster. Results: Local and systemic adverse events (AEs) were mostly mild to moderate (only 1%-3% of patients experienced severe AEs). Local, but not systemic, AEs occurred more frequently after the booster dose. Twenty-eight days after the booster vaccination of 197 cancer patients, RBD-binding antibody titers and NT50 were lower in the chemotherapy group {234.05 IU/ml [95% confidence interval (CI) 122.10-448.66] and 24.54 (95% CI 14.50-41.52), respectively} compared with healthy individuals [1844.93 IU/ml (95% CI 1383.57-2460.14) and 122.63 (95% CI 76.85-195.67), respectively], irrespective of timing of vaccination during chemotherapy cycles. Extremely low antibody responses were seen in hematology patients receiving rituximab; only two patients had RBD-binding antibody titers necessary for 50% protection against symptomatic SARS-CoV-2 infection (

Published
2021

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