INfluenza Vaccine Indication During therapy with Immune checkpoint inhibitors: a multicenter prospective observational study (INVIDIa-2)

Background Until now, no robust data supported the efficacy, safety and recommendation for influenza vaccination in patients with cancer receiving immune checkpoint inhibitors (ICIs).Methods The prospective multicenter observational INfluenza Vaccine Indication During therapy with Immune checkpoint...

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Main Authors: Diana Giannarelli, Sandro Pignata, Vincenzo Montesarchio, Massimo Di Maio, Melissa Bersanelli, Sebastiano Buti, Raffaele Giusti, Marcello Tiseo, Marco Filetti, Corrado Ficorella, Elena Verzoni, Ugo De Giorgi, Carmine Pinto, Ernesto Rossi, Evaristo Maiello, Maria R Migliorino, Annamaria Catino, Francesca Mazzoni, Francesco Grossi, Giorgia Guaitoli, Marco Maruzzo, Giuseppe Aprile, Marilena Di Napoli, Giorgia Negrini, Antonio Russo, Saverio Cinieri, Mimma Rizzo, Fable Zustovich, Vieri Scotti, Alberto Clemente, Paola Ermacora, Pamela Francesca Guglielmini, Antonello Veccia, Chiara Casadei, Francesco Verderame, Lucia Fratino, Caterina Accettura, Manlio Mencoboni, Cinzia Baldessari, Andrea Camerini, Letizia Laera, Mariella Sorarù, Paolo Andrea Zucali, Valentina Guadalupi, Francesco Leonardi, Michele Tognetto, Francesco Di Costanzo, Francesco di Costanzo, Roberto Labianca, Luigi Bernardi
Format: Article
Language:English
Published: BMJ Publishing Group 2021-05-01
Series:Journal for ImmunoTherapy of Cancer
Online Access:https://jitc.bmj.com/content/9/5/e002619.full
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Summary:Background Until now, no robust data supported the efficacy, safety and recommendation for influenza vaccination in patients with cancer receiving immune checkpoint inhibitors (ICIs).Methods The prospective multicenter observational INfluenza Vaccine Indication During therapy with Immune checkpoint inhibitors (INVIDIa-2) study investigated the clinical effectiveness of influenza vaccination in patients with advanced cancer receiving ICIs, enrolled in 82 Italian centers from October 2019 to January 2020. The primary endpoint was the time-adjusted incidence of influenza-like illness (ILI) until April 30, 2020. Secondary endpoints regarded ILI severity and vaccine safety.Results The study enrolled 1279 patients; 1188 patients were evaluable for the primary endpoint analysis. Of them, 48.9% (581) received influenza vaccination. The overall ILI incidence was 8.2% (98 patients). Vaccinated patients were significantly more frequently elderly (p<0.0001), males (p=0.004), with poor European Cooperative Oncology Group performance status (p=0.009), affected by lung cancer (p=0.01), and by other non-cancer comorbidities (p<0.0001) when compared with unvaccinated. ILI incidence was not different basing on influenza vaccination: the time-to-ILI was similar in vaccinated and unvaccinated patients (p=0.62). ILI complications were significantly less frequent for patients receiving the vaccination (11.8% vs 38.3% in unvaccinated, p=0.002). ILI-related intravenous therapies were significantly less frequent in vaccinated patients than in unvaccinated (11.8% vs 29.8%, p=0.027). ILI lethality was, respectively, 0% in vaccinated and 4.3% in unvaccinated patients. Vaccine-related adverse events were rare and mild (1.5%, grades 1–2).Conclusion The INVIDIa-2 study results support a positive recommendation for influenza vaccination in patients with advanced cancer receiving immunotherapy.
ISSN:2051-1426