ESMO Congress 2023 | OncologyPRO

Abstract 1761P

Background

Immunocompromised (IC) patients e.g., due to cancer or immunosuppressive therapy, are at increased risk for herpes zoster (HZ) with severe complications, recurrence and mortality. HZ affects up to one in three adults over 50 years, with post-herpetic neuralgia in up to one in ten HZ cases. The objective was to document HZ incidence in a broad range of IC populations, including cancer, in Europe.

Methods

A systematic literature review (2002-2022) identified observational studies reporting HZ incidence in IC populations in the European Union/European Economic Area, Switzerland and the United Kingdom.

Results

26 studies were included: five in cancer patients reported HZ incidence rates per 1,000 person-years. In mixed hematologic malignancy (HM) patient studies, overall HZ incidence was 12.0-15.2 vs 4.6-6.2 in non-IC controls, increasing with age (Table). Chronic lymphocytic leukemia (CLL) patients had an 11.3 times greater risk of HZ (incidence 2.94 vs controls 0.26). In myelofibrosis (MF) patients, ruxolitinib use increased HZ risk (incidence in long-term, short-term, new and switch users vs non-ruxolitinib users). In mixed solid organ malignancy (SOM) patient studies, overall HZ incidence was 8.8-11.0 vs 4.6-6.2 in non-IC controls, increasing with age (Table), and was higher for women vs men (10.8 vs. 9.0).

Table: 1761P

	Age group	Non-IC	HM	SOM
Spain (2009-2014)	18-29y	2.26 [2.21; 2.31]	4.96 [4.1; 5.94]	3.87 [2.59; 5.56]
50-59y	5.52 [5.44; 5.61]	13.95 [12.5; 15.52]	10.24 [9.66; 10.85]
≥80y	9.54 [9.36; 9.71]	18.44 [16.46; 20.6]	12.00 [11.43;12.59]
England (2000-2012)	18-49y	2.12 [2.03; 2.22]	8.46 [7.29; 9.77]	4.32 [3.96; 4.70]
50-59y	4.90 [4.72; 5.08]	15.41 [13.61; 17.37]	6.79 [6.36; 7.25]
≥80y	11.02 [10.64; 11.41]	17.53 [15.47; 19.79]	11.63 [11.08; 12.20]

y: year

Conclusions

This systematic review reported a higher HZ risk for HM and SOM patients, varying across countries and cancer type. Stratified data showed risk differed by age, sex and treatment. These real-world studies highlight the increased HZ risk and burden in cancer patients, which may be prevented with the adjuvanted recombinant HZ vaccine approved for multiple IC populations.

Clinical trial identification

Editorial acknowledgement

Business & Decision Life Sciences c/o GSK (Writer: Kavi Littlewood).

Legal entity responsible for the study

GSK Biologicals SA.

Funding

GSK Biologicals SA.

Disclosure

I. Posiuniene, A. Marijam, A. Bhavsar: Financial Interests, Personal, Full or part-time Employment: GSK; Financial Interests, Personal, Stocks/Shares: GSK. N. Vroom, H. Vroling: Financial Interests, Personal, Full or part-time Employment: P95/Pallas. N. Lecrenier: Financial Interests, Personal, Full or part-time Employment: GSK; Financial Interests, Personal, Stocks/Shares: GSK; Financial Interests, Personal, Advisory Board: GSK; Financial Interests, Personal, Other, NL also reports patents planned, issued or pending outside of the submitted work: GSK.