1558P - Efficacy of influenza vaccine (fluvax) in patients undergoing chemotherapy

Date 01 October 2012
Event ESMO Congress 2012
Session Poster presentation III
Topics Supportive Care
Presenter Rajiv Kumar
Authors R. Kumar1, D. Gordon2, C.S. Karapetis1, B. Koczwara1, G. Kichenadasse1, D. Dua3, H. Takhar1, K. Jain1, Y. Honda-Okubo4, S. Sukumaran3
  • 1Department Of Medical Oncology, Flinders Medical Centre, 5042 - Adelaide/AU
  • 2Department Of Medicine, Flinders University, 5042 - Adelaide/AU
  • 3Medical Oncology, Flinders Medical Centre, 5042 - Adelaide/AU
  • 4Department Of Microbiology And Infectious Diseases, Vacine Pty Ltd, Adelaide/AU

Abstract

Background

Influenza virus related-illness is a common seasonal respiratory infection. Cancer patients undergoing chemotherapy are advised to be immunised against influenza, however, the efficacy of vaccination has not been well studied. This study aimed to demonstrate the efficacy of the 2011/2012 trivalent FluVax in patients undergoing chemotherapy in comparison to healthy historical controls.

Method

Twenty-six patients with solid tumours were given one dose of 2011/2012 trivalent FluVax containing A/California/7/2009(H1N1), A/Perth/16/2009(H3N2), B/Brisbane/60/2008 strains (WHO), at least 3 days before chemotherapy. Efficacy was determined by measurement of haemagglutination inhibition (HAI) titres against component viruses in serum collected at baseline, 3, 6 and 24 weeks to assess baseline and follow up seroprotection (SP) (HAI ≥ 40) and seroconversion (SC) (≥4-fold increase titre).

Results

78 events were evaluable. The mean age was 57.6 years, with 44% of patients being male. The majority of patients had colorectal cancer (29.6%), followed by breast cancer (25.9%), non-small cell lung cancer (14.8%), ovarian cancer (7.4%). Nearly half the patients had stage IV disease (48%).

32.1% has baseline SP, with an additional 19.2% achieving SP during the study. Only 23.1% had SC. SP and SC to all 3 strains was seen in 3 patients. The majority of those with baseline SP maintained immunity during treatment. Prior FluVax was independent of achieving SP during treatment (p = 0.93). Patients <65 years were more likely to achieve SP (p = 0.016), as were men (p = 0.022). Tumour type was no predictive of SP. Patients having palliative treatments were just as likely to achieve SP compared those having curative treatments (p = 0.38). The likelihood of achieving SP was not affected by type of cytotoxic treatment, however those having monoclonal antibodies were more likely to achieve SP.

Conclusion

FluVax efficacy is suboptimal in patients with cancer undergoing chemotherapy, compared with the expected SP rate of 85-100% in healthy individuals. New approaches to improving vaccine efficacy are needed.

Disclosure

All authors have declared no conflicts of interest.