News in brief: Cancer patient vax eligibility extended; Oncology clinics cancelled due to staff COVID furloughs; Ovarian toxicity not assessed in breast cancer trials

Thursday, 26 May 2022

Cancer patient vax eligibility extended

A wider range of cancer patients is now eligible for COVID vax boosters.

Survivors of childhood cancer and all adults diagnosed with non-haematological malignancy within the past five years should begin receiving a fourth dose of COVID-19 vaccine for winter, ATAGI says.

The advice, released on Wednesday, applies to anyone aged 16-64 and covers a range of patients deemed at increased risk of severe COVID-19.

It also includes any patient on chemotherapy, radiotherapy immunotherapy, active or recently completed targeted anti-cancer therapy or anyone with advanced disease regardless of treatment.

Fourth doses were already recommended for patients with active haematological malignancies and other cancers in active treatment, along with other immunocompromised patients and anyone aged 65 years and older.

As per previous recommendations, the Pfizer and Moderna vaccines are preferred for booster doses and patients have been advised to wait three months until after their most recent SARS-CoV-2 infection before vaccination.

Oncology clinics cancelled due to staff COVID furloughs

Specialist oncologist clinics say they are being forced to close or severely cut back services due to the number of staff in isolation due to COVID-19.

With winter still a week away, Canberra Health Services says activity has already dramatically slowed in its cancer centres thanks to rising cases in the ACT.

“Last week we were missing all of our junior medical officers in our cancer service … I think largely due to COVID, but there were a few who were sick as well,” said its CEO Dave Peffer.

“To reallocate our consultants out onto the wards meant that we did have to slow the clinic activity in cancer for the better part of a week.”

Mr Peffer told the Canberra Times the strain was being felt across the ACT health system, which was now postponing 11 surgeries per day.

“That might not sound like much but that over a week you’re talking 55 to 77 surgeries, depending how many days you might impact in the theatres,” he said.

“And then very quickly, in a number of weeks, you’re in the hundreds of patients that have been impacted by slow down.”

Ovarian toxicity not assessed in breast cancer trials

Ovarian toxicity assessment is being overlooked in the design of breast cancer trials, despite the profound impact of treatment-related menopause and infertility for premenopausal women, an Australian-led study shows.

Researchers at Melbourne University and the Peter Mac Cancer Centre conducted a qualitative study to investigate why ovarian toxicity endpoints were rarely assessed in trials that enrol premenopausal women.

Feedback from oncology clinicians, regulatory agency staff, pharmaceutical company representatives and consumers showed that most believed that evaluating the impact of breast cancer treatments on ovarian function would be valuable, but most rarely considered it.

Barriers to inclusion of ovarian toxicity assessment in trials included perceptions that such data was less important than survival data and not required for regulatory approval.

Stronger advocacy is needed to change practice. Clinical trial design guidelines may break down many of the existing barriers to ovarian toxicity assessment, raise awareness of this important knowledge gap and provide guidance on how to collect informative data while minimising the burden on trial resources.

More information: The Breast.

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