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Thématique :
- Cancer colorectal (CCR)
Originalité :
Très original
Solidité :
A confirmer
Doit faire évoluer notre pratique :
Pas encore
 
 
Nom du veilleur :
Docteur Roger FAROUX
Coup de coeur :
 
 
Gastroenterology
  2018/01  
 
  2018 Jan;154(1):86-92.e1.  
  doi: 10.1053/j.gastro.2017.09.009.  
 
  Cholera Vaccine Use Is Associated With a Reduced Risk of Death in Patients With Colorectal Cancer: A Population-Based Study.  
 
  Ji J, Sundquist J, Sundquist K  
  https://www.ncbi.nlm.nih.gov/pubmed/28923497  
 
 

Abstract

BACKGROUND & AIMS:

Cholera toxin can act as a modulator of the immune response with anti-inflammatory effects; it reduces development of colon polyps in mouse models of colorectal cancer (CRC). We performed a population-based study to determine whether, in patients with a diagnosis of CRC, subsequent administration of the cholera vaccine (killed Vibrio cholerae O1 whole cells and recombinant cholera toxin B subunit) affects mortality.

METHODS:

We identified patients from the Swedish Cancer Register who were diagnosed with CRC from July 2005 through December 2012. These patients were linked to the Swedish Prescribed Drug Register to retrieve cholera vaccine use. We used Cox regression analysis to calculate the hazard ratio (HR) of death from CRC and overall mortality in patients with post-diagnostic use of cholera vaccine compared with matched controls.

RESULTS:

A total of 175 patients were diagnosed with CRC and given a prescription for the cholera vaccine after their cancer diagnosis. Compared with propensity score-matched controls and adjusted for confounding factors, patients with CRC who received the cholera vaccine had a decreased risk of death from CRC (HR, 0.53; 95% CI, 0.29-0.99) and a decreased risk of death overall (HR, 0.59; 95% CI, 0.37-0.94). The decrease in mortality with cholera vaccination was largely observed, irrespective of patient age or tumor stage at diagnosis or sex.

CONCLUSIONS:

In a population-based study, we associated administration of the cholera vaccine after CRC diagnosis with decreased risk of death from CRC and overall mortality.

 

 
Question posée
 
Une vaccination anti-choléra peut-elle avoir un impact sur la survie après le diagnostic d’un cancer colorectal ?
 
Question posée
 
A partir du registre suédois des cancers sur une période de 7 ans, 175 patients exposés à une vaccination orale contre le choléra après le diagnostic de cancer colorectal avaient un risque de mortalité liée au cancer fortement diminué (HR, 0,53;95%CI,0.29-0-99) par rapport à une population contrôle appariée. Une vaccination anti malaria, également liée aux voyages n’avait pas d’effet semblable.
 
Commentaires

Les rapports entre immunité, microbiote et carcinogénèse sont complexes. Les mécanismes immunitaires engendrés par une vaccination orale pourraient avoir un effet anti tumoral. Cette piste originale nécéssite bien sûr des confirmations.

 
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