A Prospective Study of the Factors Shaping Antibody Responses to the AS03-adjuvanted Influenza A/H1N1 Vaccine in Cancer Outpatients

Overview

Journal Oncologist

Publisher Oxford University Press

Specialty Oncology

Date 2012 Feb 24

PMID 22357731

Citations 16

Authors

Andreas F Hottinger

Anne-Claude C George

Michael Bel

Laurence Favet

Christophe Combescure

Sara Meier

Stephane Grillet

Klara Posfay-Barbe

Laurent Kaiser

Claire-Anne Siegrist

Pierre-Yves Dietrich

Affiliations

Soon will be listed here.

Abstract

Purpose: To identify the determinants of antibody responses to adjuvanted influenza A/H1N1/09 vaccines in a cohort of cancer outpatients.

Patients And Methods: Patients with cancer and controls were enrolled in a prospective single-center field study. Two doses of AS03-adjuvanted pandemic influenza vaccine were administered to patients and one dose was administered to controls. Antibody responses were measured using hemagglutination inhibition and confirmed by microneutralization. Geometric mean titers (GMTs) and seroprotection rates (defined as GMTs ≥40) were compared.

Results: Immunizations were safe and well tolerated in 197 cancer patients (lymphoma, 57; glioma, 26; lung or head and neck, 37; gastrointestinal, 41; breast, 36) and 138 controls. Similar seroprotection rates (82.3% versus 87%) and GMTs (336.9 versus 329.9) were achieved after two doses of adjuvanted vaccine in cancer patients and one dose in controls. Univariate analyses identified older age, prior immunization against seasonal influenza, lymphoma, CD4 count, active chemotherapy, and rituximab and steroid treatments as being associated with weaker antibody responses. However, only age and chemotherapy plus rituximab remained independent determinants of vaccine responses in multivariate analyses.

Conclusions: Two doses of AS03-adjuvanted influenza vaccine elicited potent antibody responses in most cancer patients despite ongoing chemotherapy, with the exception of rituximab-induced B-cell depletion. Oncology patients treated in an outpatient setting benefit from preventive vaccination against influenza with adjuvanted vaccines.

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