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Immunogenicity of Influenza Vaccine in Patients With Lung Cancer Under Chemotherapy FREE TO VIEW

Kei Nakashima; Satoko Ohfuji; Masahiro Aoshima; Kanzo Suzuki; Kyoko Kondo; Yoshio Hirota
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Department of Public Health, Osaka City University Faculty of Medicine, Osaka, Japan

Chest. 2015;148(4_MeetingAbstracts):81A. doi:10.1378/chest.2270362
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SESSION TITLE: Chest Infections

SESSION TYPE: Original Investigation Slide

PRESENTED ON: Sunday, October 25, 2015 at 01:30 PM - 03:00 PM

PURPOSE: We conducted the prospective study to evaluate the immunogenicity of patients with lung cancer under chemotherapy in this new period.

METHODS: The study subjects were patients with lung cancer under chemotherapy or chronic obstructive lung disease (COPD) as a control, recruited from Kameda Medical Center, Japan. A total of 25 patients with lung cancer and 27 patients with COPD were enrolled. Fluvic HA syringe® (Handai Biken Ltd) 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 at 3 time points: before vaccination (S0); 4 to 6 weeks after the first dose (S1); and April 2014 after a full season; (S2). The following outcomes were calculated to assess the immunogenicity of influenza vaccine: the geometric mean titer; the fold rise; the seroresponse rate (sR) (>4-fold rise); and the seroprotection rate (sP) (postvaccination titer >1:40). Stratified analyses were performed to examine the effect of the following potential confounders: age at vaccination (median); gender (man and woman); prevaccination titer (<1:10 and >1:10) and underlying disease (COPD and lung cancer). Furthermore, the independent effects of potential confounders on antibody induction were evaluated by logistic regression.

RESULTS: In the multivariate analysis, the adjusted odds ratios for lung cancer patients versus COPD patients for sP and sR were as follows; A/California/7/2009(H1N1)pdm09 vaccine: sP 1.25 (95%CI 0.23-6.9; p=0.801), sR 1.29(95%CI 0.27-6.29; p=0.749), A/texas/50/2012 (H3N2): sP 0.30 (95%CI 0.02-4.01; p=0.364), sR 1.11 (95%CI 0.30-4.15; p=0.872) , B/Massachusetts/2/2012: sP 0.11 (95%CI 0.01-0.79; p=0.028), sR 1.02(95%CI 0.28-3.78; p=0.975).

CONCLUSIONS: In the vaccination of A/California/7/2009(H1N1)pdm09 and A/texas/50/2012 (H3N2), there were no significant reductions in the ORs for underlying disease in sP and sR. However, in the vaccination of B/Massachusetts/2/2012, the OR in patients with lung cancer was significantly low in sP. The Immunogenicity might be different depending on the vaccine strain. This study was supported by a research grant for Research on Emerging and Re-emerging Infectious Diseases, Health and Labour Sciences Research Grants from the Ministry of Health, Labor and Welfare, Japan (H23-SHINKO-IPPAN-017).

CLINICAL IMPLICATIONS: Influenza vaccine might be better to be given to lung cancer patients before initiation of chemotherapy or between courses of chemotherapy.

DISCLOSURE: Masahiro Aoshima: Consultant fee, speaker bureau, advisory committee, etc.: He received speaking fees from KYORIN Pharmaceutical Co., Ltd., Tokyo, Japan., Consultant fee, speaker bureau, advisory committee, etc.: He received speaking fees from MSD K.K. a subsidiary of Merck & Co., Inc., Kenilworth, N.J., U.S.A. The following authors have nothing to disclose: Kei Nakashima, Satoko Ohfuji, Kanzo Suzuki, Kyoko Kondo, Yoshio Hirota

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