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Covid: life-saving pre-intervention vaccine in cancer patients

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Milan, 25 March (beraking latest news Salute) – Priority anti-Covid vaccination for those who have to undergo surgery, especially against cancer. This is the request launched to the international health authorities, including the Italian ones, based on the results of a study coordinated by the University of Birmingham (Gb) and developed in collaboration with the National Cancer Institute (Int) of Milan. The work, published in the British Journal of Surgery, demonstrated for the first time the lifesaving efficacy of Sars-CoV-2 prophylaxis in cancer patients undergoing surgery. The authors of the research, out of 141,582 patients in 1,667 hospitals in 116 countries, calculate that preoperative anti-Covid vaccination could prevent almost 60,000 deaths associated with coronavirus infection every year.

This is the “largest study ever conducted in the world for the number of patients enrolled”, explained by the Irccs Int Foundation of the Lombard capital. In addition to Italy and the UK, among the nations involved there are also Australia, Brazil, China, India, the United Arab Emirates and the United States. Italy participated with 115 centers, second only to the United Kingdom with 205. The ‘CovidSurg Collaborative’ team completed the research in record time, showing that “in patients candidates for surgery, anti-Covid vaccination could prevent over 58 thousand deaths per year related to infection. An even more relevant figure – it is emphasized – if we consider that, during the first wave of the pandemic, around 7 out of 10 interventions in the world were postponed and that 28 million procedures were delayed or canceled “.

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And “the situation was certainly no better by analyzing only the Italian data – highlight from the Int – A survey involving 54 reference surgical oncological units in 36 hospitals throughout the country showed a reduction of about a third of surgical interventions during the first 5 weeks from the start of the emergency. This percentage reached about 50% fewer surgical procedures in the most affected region, Lombardy “. Data that are added to another: “Cancer patients have a risk up to 3.5 times greater than the general population of getting sick with Covid”, and therefore should have guaranteed continuity of care and any more appropriate treatment.

“From the study – says Marco Fiore, surgeon oncologist of the Sarcoma Surgery Service of the Int and coordinator of the study for the Milanese IRCCS – it appears that vaccinating patients who are candidates for surgery (and among these, of course, cancer patients have a priority as they cannot postponing the procedure and having to undergo the on average more complex surgical procedures), is a priority over vaccinating the general population, because these are more fragile patients for whom contracting the virus in the perioperative period carries a much higher risk of death “.

“Potentially – continues the specialist – this could help prevent tens of thousands of post-operative deaths related to the virus. For the same vaccine doses administered, in fact, vaccinating cancer patients who are candidates for surgery can prevent 11 to 131 times more deaths from Covid-19 compared to vaccination of the general population of the same age group. The study showed that among the patients candidates for surgery the population that in particular would benefit most is that of cancer patients, the most fragile, with particular attention to the over 70s who have the greatest fatality rate from Covid 19 due to age “.

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“Although at the moment there are several vaccines with broad indications and which formally allow to vaccinate even patients with cancer, cancer patients were not recruited or were minimally recruited in the studies on which the approvals of the various regulatory agencies were based – comments Giovanni Apolone, scientific director of the Int – We do not know with certainty, at the moment, if the immunological coverage after vaccination in these patients is the same as that of the general population. These data, therefore, are very important as they begin to fill a gap cognitive, of particular importance as it derives from data from the real world. The next priority is therefore to produce this type of data also in non-surgical patients, suffering from oncological diseases who receive anticancer therapies that can potentially interfere with the immune response, after vaccinations Many studies are underway, including one at a national level i n Italy, where our Institute is one of the coordinating centers “.

“With the intention of pursuing the best possible therapeutic strategy for each individual patient – declares Alessandro Gronchi, head of the Sarcoma Surgery Service of the Int of Milan and president of the Italian Society of Oncological Surgery (Sico) – as Sico we believe that a reorganization of the management of surgical cancer patients based on the creation of efficient cancer networks and, where already present, on their strengthening “.

“The model we propose – specifies the expert – is based on a collaborative network such as the Comprehensive Cancer Care Network, adapted to face the state of emergency and subsequent recovery, but also to improve the ordinary quality standard”.

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“Furthermore – concludes Gronghi – with the ‘Sico4Regions’ project, Sico aims to create region-specific programs that act on three levels: management of the surgical oncology patient, which we would like to also include pre-surgical anti-Covid vaccination; the creation a pathology register through the involvement of Sico OncoTeams, and assistance in defining priorities and redistributing resources at the time of the exit from the health crisis “.

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