Efficacy of influenza vaccine (FluVax) in patients on chemotherapy (POCT): final data analysis from South Australia

Date

09 Oct 2016

Session

Poster display

Presenters

Adeola Ayoola

Citation

Annals of Oncology (2016) 27 (6): 497-521. 10.1093/annonc/mdw390

Authors

A. Ayoola1, S. Sukumaran2, R. Kumar1, D. Gordon3, A. Roy4, S. Vantandoust1, B. Koczwara2, G. Kichenadasse2, C. Karapetis4

Author affiliations

  • 1 Department Of Medical Oncology, Flinders Medical Center, 5042 - Bedford Park/AU
  • 2 Medical Oncology, Flinders Medical Centre and Flinders University, 5042 - Adelaide/AU
  • 3 Department Of Microbiology And Infectious Diseases, Flinders Medical Center, 5042 - Bedford Park/AU
  • 4 Medical Oncology, Flinders Medical Centre and Flinders University, Adelaide/AU
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Background

Influenza (flu) virus infection has a significant morbidity and mortality in excess of 5-10% especially in patients with medical co-morbidities who are also immune-suppressed. Influenza vaccination decreases all-cause mortality by about 30-50%. Patients undergoing chemotherapy along with the general public are vaccinated annually; there has been no study to assess the efficacy of influenza vaccination in these groups (patients on chemotherapy- POCT).

Methods

This is a prospective single arm, phase II open label study. 53 POCT with non-haematological cancers were recruited between 2011 and 2012 influenza seasons. POCT vaccinated in the current influenza season were excluded. Participants had one dose of 2011/2012 trivalent FluVax containing strains A/California/7/2009(H1N1); A/Perth/16/2009 (H3N2); B/Brisbane/60/2008 at least 3 days before chemotherapy. Primary endpoint was early seroconversion (SC) rate at 3weeks; other end-points were late SC rate at 6weeks; sustained SC and sero-protection (SP) at 24 weeks. Haem-agglutination inhibition (HAI) titres in serum were measured at baseline, 3, 6 and 24 weeks. Endpoint defined as SP (HAI ≥ 40); SC (≥4-fold increase titre).

Results

53 patients; mean (sd) age 58.3(10.5) years; n(%) of Females 31(58.5). The results are displayed in the table below.

Proportion N (%)
Baseline 3weeks 6weeks 6months
Seroconversion
A/California/7/2009 (H1N1) 0 14 (35%) 14 (31.8%) 3 (7.5%)
A/Perth/16/2009(H3N2) 0 12 (30%) 12 (27.3%) 7 (17.5%)
B/Brisbane/60/2008 0 9 (22.5%) 8 (18.2%) 3 (7.5%)
Seroprotection
A/California/7/2009 (H1N1) 23 (47.9%) 30 (75%) 33(75%) 16 (40%)
A/Perth/16/2009(H3N2) 19 (39.58%) 26 (65%) 26 (59.1%) 21 (52.5%)
B/Brisbane/60/2008 17 (42.5%) 17 (42.5%) 14 (31.8%) 8 (20%)

Conclusions

POCT might have sub-optimal response to the FluVax. Our findings should be confirmed in a larger patient population and warrants further research into a more effective strategy in this patient group.

Clinical trial identification

ACTRN:12611000306910

Legal entity responsible for the study

Southern Adelaide Health Network Inc

Funding

N/A

Disclosure

All authors have declared no conflicts of interest.

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