Lopez-Olivo Maria A, Valerio Valeria, Karpes Matusevich Aliza R, Brizio Marianela, Kwok Michelle, Geng Yimin, Suarez-Almazor Maria E, Colmegna Ines
Department of Health Services Research, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1444, Houston, TX 77030, USA.
The Research Institute of the McGill University Health Centre (RI-MUHC), Montreal, QC H4A 3J1, Canada.
Vaccines (Basel). 2022 Jul 27;10(8):1195. doi: 10.3390/vaccines10081195.
The potential increased risk of immune-related adverse events (irAEs) post-influenza vaccine is a concern in patients receiving immune checkpoint inhibitors (ICI). We conducted a systematic review with meta-analysis of studies reporting the effects of influenza vaccination in patients with cancer during ICI treatment. We searched five electronic databases until 01/2022. Two authors independently selected studies, appraised their quality, and collected data. The primary outcome was the determination of pooled irAE rates. Secondary outcomes included determination of immunogenicity and influenza infection rates and cancer-related outcomes. Nineteen studies (26 publications, n = 4705) were included; 89.5% were observational. Vaccinated patients reported slighter lower rates of irAEs compared to unvaccinated patients (32% versus 41%, respectively). Seroprotection for influenza type A was 78%-79%, and for type B was 75%. Influenza and irAE-related death rates were similar between groups. The pooled proportion of participants reporting a laboratory-confirmed infection was 2% (95% CI 0% to 6%), and influenza-like illness was 14% (95% CI 2% to 32%). No differences were reported on the rates of laboratory-confirmed infection between vaccinated and unvaccinated patients. Longer progression-free and overall survival was also observed in vaccinated compared with unvaccinated patients. Current evidence suggests that influenza vaccination is safe in patients receiving ICIs, does not increase the risk of irAEs, and may improve survival.
对于正在接受免疫检查点抑制剂（ICI）治疗的患者而言，流感疫苗接种后免疫相关不良事件（irAE）潜在风险增加是一个令人担忧的问题。我们进行了一项系统评价并荟萃分析，纳入报告ICI治疗期间流感疫苗接种对癌症患者影响的研究。我们检索了五个电子数据库至2022年1月。两位作者独立选择研究、评估其质量并收集数据。主要结局是确定合并的irAE发生率。次要结局包括确定免疫原性、流感感染率以及癌症相关结局。纳入了19项研究（26篇出版物，n = 4705）；89.5%为观察性研究。与未接种疫苗的患者相比，接种疫苗的患者报告的irAE发生率略低（分别为32%和41%）。甲型流感的血清保护率为78% - 79%，乙型流感为75%。两组之间流感和irAE相关死亡率相似。报告实验室确诊感染的参与者合并比例为2%（95%CI 0%至6%），流感样疾病为14%（95%CI 2%至32%）。接种疫苗和未接种疫苗的患者在实验室确诊感染率方面未报告差异。与未接种疫苗的患者相比，接种疫苗的患者还观察到更长的无进展生存期和总生存期。目前的证据表明，流感疫苗接种对接受ICI治疗的患者是安全的，不会增加irAE的风险，并且可能改善生存期。
