Immunogenicity of an Inactivated Monovalent 2009 Influenza A (H1N1) Vaccine in Patients Who Have Cancer

Xu, Yiqing; Methuku, Nanda K.; Coimbatore, Praveena; Fitzgerald, Theresa; Huang, Yiwu; Xiao, Ying-Yi; Pagala, Murali; Gupta, Shachi; Solomon, William B.; Rubin, Philip; Treanor, John J.; Astrow, Alan B.; Minkoff, Howard; Cooper, Jay S.

doi:10.1634/theoncologist.2011-0220

Cited by 17 publications

(15 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Despite the dysfunction in the tumor environment and in systemic immune populations, when tested with standard vaccines there is little evidence that cancer patients are functionally immunosuppressed [38]. Our data with Listeria vaccination agrees with these clinical studies.…”

Section: Discussionsupporting

confidence: 84%

The Peripheral Myeloid Expansion Driven by Murine Cancer Progression Is Reversed by Radiation Therapy of the Tumor

et al. 2013

View full text Add to dashboard Cite

Expansion of myeloid-lineage leukocytes in tumor-bearing mice has been proposed as a cause of systemic immunosuppression. We demonstrate that radiation therapy of tumors leads to a decline in myeloid cell numbers in the blood and a decrease in spleen size. The frequency of myeloid cells does not decline to the level seen in tumor-free mice: we demonstrate that metastatic disease can prevent myeloid cell numbers from returning to baseline, and that tumor recurrence from residual disease correlates with re-expansion of myeloid lineage cells. Radiation therapy results in increased proliferation of T cells in the spleen and while T cell responses to foreign antigens are not altered by tumor burden or myeloid cell expansion, responses to tumor-associated antigens are increased after radiation therapy. These data demonstrate that myeloid cell numbers are directly linked to primary tumor burden, that this population contracts following radiation therapy, and that radiation therapy may open a therapeutic window for immunotherapy of residual disease.

show abstract

Section: Discussionsupporting

confidence: 84%

The Peripheral Myeloid Expansion Driven by Murine Cancer Progression Is Reversed by Radiation Therapy of the Tumor

et al. 2013

View full text Add to dashboard Cite

show abstract

“…3 The reported seroprotection rates (sPs; postvaccination titer > 1:40) of the inactivated influenza vaccine in patients with solid cancers ranges from 38%-78%. [9][10][11] The intensity and type of chemotherapy and the timing of vaccination in the course of chemotherapy influence the immunogenicity of influenza vaccination. 3 Lung cancer is the leading cause of cancer-related death among men and women.…”

Section: Introductionmentioning

confidence: 99%

Immunogenicity of trivalent influenza vaccine in patients with lung cancer undergoing anticancer chemotherapy

Nakashima

Aoshima

Ohfuji

et al. 2016

Human Vaccines & Immunotherapeutics

View full text Add to dashboard Cite

Lung cancer is a leading cause of cancer-related death, and patients with lung cancer are a priority group for influenza vaccination. However, few studies have assessed the immunogenicity of the influenza vaccine in these patients. Here, we performed a prospective study to evaluate the immunogenicity of the influenza vaccine in patients with lung cancer undergoing anticancer chemotherapy. Twenty-five patients with lung cancer undergoing anticancer chemotherapy and 26 patients with chronic obstructive pulmonary disease (COPD) as controls were enrolled. A trivalent influenza vaccine containing inactivated A/California/7/2009 (H1N1) pdm09, A/Texas/50/2012 (H3N2), and B/Massachusetts/2/2012 was administered as a single subcutaneous injection. Serum samples were collected before vaccination, and at 4-6 weeks after vaccination. Levels of serum antibody to hemagglutinin were measured. Among patients with lung cancer, the seroprotection rate (postvaccination titer > 1:40) was 84% for both A(H1N1) and A(H3N2), similar to the levels observed in patients with COPD. However, the seroprotection rate for the B strain was significantly lower in patients with lung cancer than in patients with COPD (64% versus 92%). Even after adjustment for potential confounders, patients with lung cancer had a significantly lower odds ratio for seroprotection against the B strain than patients with COPD. Moreover, in patients with lung cancer, those receiving the platinum doublet treatment tended to exhibit a lower seroprotection rate than those receiving a single agent. Thus, patients with lung cancer undergoing anticancer chemotherapy showed acceptable immune responses to a trivalent influenza vaccine, supporting the recommendation for annual influenza vaccination in these patients.

show abstract

“…The paper by Xu et al [8] confirms this. Clinicians may wish to consider additional methods to enhance the immunologic response, such as using an adjuvanted vaccine or intradermal injection, especially in individual patients who might be less likely to respond to a single dose of vaccine.…”

mentioning

confidence: 69%

“…Xu et al [8] examined the immunogenicity of the 2009 H1N1 vaccine in a variety of cohorts, including patients with solid tumors on myelosuppressive chemotherapy, patients with solid tumors on nonmyelosuppressive treatment or no treatment, patients with hematologic malignancies, and healthy controls. The study was a single-center trial with a relatively small number of subjects (n ϭ 146).…”

mentioning

confidence: 99%

Vaccination of Oncology Patients: An Effective Tool and an Opportunity Not to Be Missed

Kotton

Poznansky

2012

The Oncologist

View full text Add to dashboard Cite

Vaccinating immunocompromised patients for common infectious diseases, including influenza, is a commonly missed opportunity. Clinicians caring for immunocompromised individuals often focus on other more immediate health concerns, or may believe that vaccines do not provide worthwhile protection or could even be harmful. In a recent series of 112 oncology patients at a single center in France, only 34 (30%) had undergone vaccination against influenza in the past year [1]. Numerous studies have shown reasonable rates of seroprotection and seroconversion in a variety of immunocompromised hosts, including oncology patients, with very minimal downside. Therefore, seasonal flu vaccination is broadly recommended across immunocompromised patient populations [2][3][4]. Bogoch et al. [5] demonstrated that the recent H1N1 influenza pandemic caused severe illness in a cohort of immunocompromised solid organ and bone marrow transplant patients from our hospitals. The hospitalization rate in this transplant setting was 71%, which far exceeded the hospitalization rate among confirmed cases in the general population, generally Ͻ5%. Given the severity of the H1N1 pandemic, wide-scale vaccination was recommended for immunocompromised subjects, including oncology patients [6,7]. Xu et al. [8] examined the immunogenicity of the 2009 H1N1 vaccine in a variety of cohorts, including patients with solid tumors on myelosuppressive chemotherapy, patients with solid tumors on nonmyelosuppressive treatment or no treatment, patients with hematologic malignancies, and healthy controls. The study was a single-center trial with a relatively small number of subjects (n ϭ 146). Seroconversion, seroprotection, and increases in antibody titers were not statistically different in any of the cohorts, although there was a trend toward lesser immunologic responses in those on myelosuppressive chemotherapy. Immune responses were generally fairly robust, regardless of malignancy: seroconversion was noted in 80% of healthy controls and 72%-87% of oncology patients, whereas the seroprotection rate was 96% in healthy controls and 79%-91% in oncology patients. Myelosuppressive therapy was highly varied and included corticosteroids; biologics such as imatinib, sorafinib, sunitinib, and rituximab; and cytotoxic chemotherapy agents considered to have immunosuppressive potential, such as fludarabine, cyclophosphamide, 5-fluorouracil, 6-mercaptopurine, cytarabine, L-asparaginase, and vinca alkaloids. Because of the extremely varied nature of the therapy, no conclusions could be drawn about the impact of specific agents.Immune responses in these patients were reasonably robust, especially when compared with other trials, and were comparable with those in healthy controls. In another recent oncology trial, for example, the seroprotection rates after influenza vaccination were 50% for those with solid tumors and 27% for those with hematological malignancies (p ϭ .11), whereas the respective seroconversion rates were 45% and 19% (p ϭ .06) [9]. In another trial of...

show abstract

Immunogenicity of an Inactivated Monovalent 2009 Influenza A (H1N1) Vaccine in Patients Who Have Cancer

Cited by 17 publications

References 45 publications

The Peripheral Myeloid Expansion Driven by Murine Cancer Progression Is Reversed by Radiation Therapy of the Tumor

The Peripheral Myeloid Expansion Driven by Murine Cancer Progression Is Reversed by Radiation Therapy of the Tumor

Immunogenicity of trivalent influenza vaccine in patients with lung cancer undergoing anticancer chemotherapy

Vaccination of Oncology Patients: An Effective Tool and an Opportunity Not to Be Missed

Contact Info

Product

Resources

About