tetano
Editor, Senior Moderator
Clin Infect Dis. 2019 Mar 15. pii: ciz202. doi: 10.1093/cid/ciz202. [Epub ahead of print]
[h=1]Safety of Inactivated Influenza Vaccine in Cancer Patients Receiving Immune Checkpoint Inhibitors (ICI).[/h] Chong CR[SUP]1[/SUP], Park VJ[SUP]2[/SUP], Cohen B[SUP]3,[/SUP][SUP]4[/SUP], Postow MA[SUP]5[/SUP], Wolchok JD[SUP]5[/SUP], Kamboj M[SUP]6,[/SUP][SUP]7[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Cancer patients are at a higher risk for developing influenza (flu) related complications. It is unclear if the flu vaccine exacerbates immune events in patients treated with ICIs.
[h=4]METHODS:[/h] We conducted an IRB-approved retrospective review of advanced cancer patients on ICIs who received the flu vaccine during three consecutive seasons; 2014-15, 15-16, and 16-17. The primary outcome assessed was any "new onset" immune-related adverse event (IRAE). A subset analysis of vaccinated patients newly treated with anti PD-1 agents (nivolumab or pembrolizumab) was conducted to assess overall IRAE rates for comparison with published clinical trials.
[h=4]RESULTS:[/h] During the three seasons, 370 patients met criteria for ICI and vaccination within ~ two months (65 days). The most common underlying cancers were lung (46%) and melanoma (19%); 61% of patients received anti PD-1 agent only. In the entire cohort, 20% experienced an IRAE (any grade); incidence of grade 3 or 4 toxicity was 8%. No grade 5 events occurred. In the subset of 170 patients newly treated with anti PD-1 agents, overall IRAE rate was 18%, grade 3/4 events occurred in 7.6%. Influenza was diagnosed in 2 patients.
[h=4]CONCLUSION:[/h] No increase in incidence or severity of IRAE was detected in patients on ICIs who received the inactivated influenza vaccine within ~ 2 months of ICI. For newly treated patients on anti-PDI agents, IRAE rates were comparable to published clinical trials and did not vary with order of administration. Routine seasonal flu vaccination is encouraged in patients on ICIs.
? The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.
[h=4]KEYWORDS:[/h] Immune checkpoint inhibitors; influenza vaccine; safety
PMID: 30874791 DOI: 10.1093/cid/ciz202
[h=1]Safety of Inactivated Influenza Vaccine in Cancer Patients Receiving Immune Checkpoint Inhibitors (ICI).[/h] Chong CR[SUP]1[/SUP], Park VJ[SUP]2[/SUP], Cohen B[SUP]3,[/SUP][SUP]4[/SUP], Postow MA[SUP]5[/SUP], Wolchok JD[SUP]5[/SUP], Kamboj M[SUP]6,[/SUP][SUP]7[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Cancer patients are at a higher risk for developing influenza (flu) related complications. It is unclear if the flu vaccine exacerbates immune events in patients treated with ICIs.
[h=4]METHODS:[/h] We conducted an IRB-approved retrospective review of advanced cancer patients on ICIs who received the flu vaccine during three consecutive seasons; 2014-15, 15-16, and 16-17. The primary outcome assessed was any "new onset" immune-related adverse event (IRAE). A subset analysis of vaccinated patients newly treated with anti PD-1 agents (nivolumab or pembrolizumab) was conducted to assess overall IRAE rates for comparison with published clinical trials.
[h=4]RESULTS:[/h] During the three seasons, 370 patients met criteria for ICI and vaccination within ~ two months (65 days). The most common underlying cancers were lung (46%) and melanoma (19%); 61% of patients received anti PD-1 agent only. In the entire cohort, 20% experienced an IRAE (any grade); incidence of grade 3 or 4 toxicity was 8%. No grade 5 events occurred. In the subset of 170 patients newly treated with anti PD-1 agents, overall IRAE rate was 18%, grade 3/4 events occurred in 7.6%. Influenza was diagnosed in 2 patients.
[h=4]CONCLUSION:[/h] No increase in incidence or severity of IRAE was detected in patients on ICIs who received the inactivated influenza vaccine within ~ 2 months of ICI. For newly treated patients on anti-PDI agents, IRAE rates were comparable to published clinical trials and did not vary with order of administration. Routine seasonal flu vaccination is encouraged in patients on ICIs.
? The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.
[h=4]KEYWORDS:[/h] Immune checkpoint inhibitors; influenza vaccine; safety
PMID: 30874791 DOI: 10.1093/cid/ciz202