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2019-6-20 4:18:51


Chong CR, et al. Safety of Inactivated Influenza Vaccine in Cancer Patients Receiving Immune Checkpoint Inhibitors (ICI). Clin Infect Dis. 2019 Mar 15.
submited by kickingbird at Mar, 17, 2019 10:58 AM from Clin Infect Dis. 2019 Mar 15.

BACKGROUND:
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.
METHODS:
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.
RESULTS:
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.
CONCLUSION:
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.

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