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

Abstract

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.

Seasonal influenza vaccine in immunocompromised persons

“…A recent prospective study to evaluate the immunogenicity of the influenza vaccine in patients with lung cancer undergoing anticancer chemotherapy included 25 patients with lung cancer and 26 patients with chronic obstructive pulmonary disease (COPD) as controls. 78 Lung cancer patients who received trivalent influenza vaccine had post-vaccination seroprotection rates of 84% for both A(H1N1) and A(H3N2), similar to the levels observed in patients with chronic obstructive pulmonary disease, but had significantly lower odds for seroprotection against the B strain. Thus, the response to influenza vaccine may be dependent of the type of influenza strain as well as the type of chemotherapy.…”

Immunological and clinical efficacy of COVID-19 vaccines in immunocompromised populations: a systematic review

“…Available data with other vaccines indicate a lower vaccine immunogenicity and efficacy in immunocompromised patients, such as patients undergoing haemodialysis, solid organ transplant recipients [ 7 , 8 ], patients with cancer or haematological malignancy [ 9 , 10 ] and those with autoimmune inflammatory diseases [ 11 ], hence raising the concern of potentially decreased immunogenicity and effectiveness of COVID-19 vaccines.…”

COVID-19 vaccine development from the perspective of cancer patients

“…Among lung cancer patients, patients receiving double-platinum chemotherapy showed lower seroprotection rates than patients receiving single-drug therapy. 35 This study showed that the immune response of the vaccine was weakened in an immunosuppressed individual.…”

“…The immune function of cancer patients is weakened during the cancer treatment; thus, the immunity to the virus is reduced. 34,35 Therefore, vaccination of live attenuated vaccines is not recommended for cancer patients.…”