[Latent infection screening before initiating immunosuppressive cancer treatment]
Clavet-Fournier V
Record ID 32018016050
French
Original Title:
Dépistage d’infections latentes avant l’amorce d’un traitement immunosuppresseur contre le cancer
Authors' objectives:
To support clinicians in selecting appropriate screening strategies prior to initiating cancer
treatment and in implementing key elements of the post-screening process, while
promoting harmonized practices across the province and reducing the use of clinically
unnecessary testing.
Authors' results and conclusions:
RESULTS: (#1 RECOMMENDATIONS BASED ON THE TARGET OF ANTICANCER THERAPY): The clinical tool organizes screening recommendations by the therapeutic targets of
anticancer therapies, including specific blood cells (B lymphocytes, T lymphocytes or
both) or cellular signaling pathways (mammalian target of rapamycin, tyrosine kinase,
proteasome, histone deacetylase, deoxyribonucleic acid replication, microtubule function
and glucocorticoid receptors).
(#2 ROUTINE SCREENING RECOMMENDED): Screening for hepatitis B and C viruses and HIV is recommended for all individuals prior
to initiating immunosuppressive cancer therapy, irrespective of the treatment regimen.
Routine screening for these infections is considered the most effective strategy for
identifying individuals who may benefit from management of the infection before initiating
immunosuppressive therapy.
(#3 SCREENING BY RISK FACTORS): For tuberculosis infection, certain immunosuppressive therapies are important risk factors
for reactivation. Consequently, screening is recommended for all individuals initiating
these therapies, regardless of the presence of exposure risk factors. This is the case for
ruxolitinib, bendamustine and glucocorticoid receptor agonists. (#4 SCREENING RECOMMENDED FOR CERTAIN IMMUNOSUPPRESSIVE THERAPIES): For the remaining latent infections, namely VZV, HSV, CMV, and EBV, screening is
recommended for some but not for others. Implementation of the clinical tool’s
recommendations could reduce the number of screening tests ordered by ensuring that
only those relevant to guiding clinical management are performed. CONCLUSION: The practice changes that may result from this work will depend on the dissemination of
the clinical tool accompanying this report and on the adoption of the clinical information
and recommendations by the relevant health professionals.
Authors' methods:
A systematic search was conducted to identify clinical practice guidelines
published from November 2014 to September 2025 that addressed screening for
targeted latent infections (HIV, HBV, HCV, HSV, VZV, CMV, EBV, TB, and
parasitic strongyloidiasis) in the context of immunosuppressive cancer therapy
Details
Project Status:
Completed
Year Published:
2026
URL for published report:
https://www.inesss.qc.ca/publications/repertoire-des-publications/publication/depistage-dinfections-latentes-avant-lamorce-dun-traitement-immunosuppresseur-contre-le-cancer.html
English language abstract:
An English language summary is available
Publication Type:
Other
Country:
Canada
Province:
Quebec
MeSH Terms
- Neoplasms
- Latent Infection
- Immunosuppressive Agents
- Immunosuppression Therapy
- Immunocompromised Host
- Mass Screening
Contact
Organisation Name:
Institut national d'excellence en sante et en services sociaux
Contact Address:
L'Institut national d'excellence en sante et en services sociaux (INESSS) , 2021, avenue Union, bureau 10.083, Montreal, Quebec, Canada, H3A 2S9;Tel: 1+514-873-2563, Fax: 1+514-873-1369
Contact Name:
demande@inesss.qc.ca
Contact Email:
demande@inesss.qc.ca
Copyright:
L'Institut national d'excellence en sante et en services sociaux (INESSS)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.