In a nutshell
This study investigated the effect of immune-checkpoint inhibitors (ICIs) on influenza vaccination in patients with cancer. They found that influenza vaccination is safe in these patients.
Some background
Immune-checkpoint inhibitors (ICIs) are a new type of drug to treat cancer. ICIs can be effective in some advanced cancers, including lung cancer. ICIs block certain proteins that cancer cells use to avoid the immune system. This leads to the immune system recognizing and fighting cancer cells. Ipilimumab (Yervoy), pembrolizumab (Keytruda) and nivolumab (Opdivo) are ICIs.
There is some concern that ICIs might affect other aspects of cancer treatment. Usually, patients are encouraged to get vaccinated against the seasonal flu. Influenza vaccination (flu shot) is important as cancer patients have a weakened immune system. It is unclear if influenza vaccination has an effect on ICI treatment.
Methods & findings
This study included 370 patients with cancer. 46% of these had lung cancer. They received influenza vaccination within 65 days of starting ICI treatment. These patients were vaccinated over 3 flu seasons. The authors analyzed immune-related (IR) side effects.
20% of all patients experienced a new IR side effect. 60% of these side effects were mild-moderate. 36% were severe. 3 (4%) patients experienced a life-threatening IR side effect. The most common side effects reported were hormonal problems, pneumonia or inflammation of the intestine lining.
Most of these side effects were managed using medication to reduce the immune system (steroids). Some patients also stopped taking ICIs for a period of time. High dose vaccines were more likely to cause IR side effects. Patients taking ipilimumab and nivolumab together had higher rates of severe to life-threatening side effects.
The bottom line
The authors concluded that influenza vaccination is safe for patients with cancer treated with ICIs. They encourage annual vaccination for these patients.
The fine print
This study did not include patients that were not vaccinated for comparison. Also, information about some side effects may have been missing, as this was based on medical records.
What’s next?
If you have any concerns regarding cancer treatment side effects, please consult with your doctor.
Published By :
Clinical infectious diseases: an official publication of the Infectious Diseases Society of America
Date :
Mar 15, 2019
