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@article{Awadalla:2019:10.1186/s40425-019-0535-y,
author = {Awadalla, M and Golden, DLA and Mahmood, SS and Alvi, RM and Mercaldo, ND and Hassan, MZO and Banerji, D and Rokicki, A and Mulligan, C and Murphy, SPT and Jones-O'Connor, M and Cohen, JV and Heinzerling, LM and Armanious, M and Sullivan, RJ and Damrongwatanasuk, R and Chen, CL and Gupta, D and Kirchberger, MC and Moslehi, JJ and Shah, SP and Ganatra, S and Thavendiranathan, P and Rizvi, MA and Sahni, G and Lyon, AR and Tocchetti, CG and Mercurio, V and Thuny, F and Ederhy, S and Mahmoudi, M and Lawrence, DP and Groarke, JD and Nohria, A and Fradley, MG and Reynolds, KL and Neilan, TG},
doi = {10.1186/s40425-019-0535-y},
journal = {Journal for ImmunoTherapy of Cancer},
title = {Influenza vaccination and myocarditis among patients receiving immune checkpoint inhibitors},
url = {http://dx.doi.org/10.1186/s40425-019-0535-y},
volume = {7},
year = {2019}
}

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TY  - JOUR
AB  - BackgroundInfluenza vaccination (FV) is recommended for patients with cancer. Recent data suggested that the administration of the FV was associated with an increase in immune-related adverse events (irAEs) among patients on immune checkpoint inhibitors (ICIs). Myocarditis is an uncommon but serious complication of ICIs and may also result from infection with influenza. There are no data testing the relationship between FV and the development of myocarditis on ICIs.MethodsPatients on ICIs who developed myocarditis (n = 101) (cases) were compared to ICI-treated patients (n = 201) without myocarditis (controls). A patient was defined as having the FV if they were administered the FV from 6 months prior to start of ICI to anytime during ICI therapy. Alternate thresholds for FV status were also tested. The primary comparison of interest was the rate of FV between cases and controls. Patients with myocarditis were followed for major adverse cardiac events (MACE), defined as the composite of cardiogenic shock, cardiac arrest, hemodynamically significant complete heart block and cardiovascular death.ResultsThe FV was administered to 25% of the myocarditis cases compared to 40% of the non-myocarditis ICI-treated controls (p = 0.01). Similar findings of lower rates of FV administration were noted among myocarditis cases when alternate thresholds were tested. Among the myocarditis cases, those who were vaccinated had 3-fold lower troponin levels when compared to unvaccinated cases (FV vs. No FV: 0.12 [0.02, 0.47] vs. 0.40 [0.11, 1.26] ng/ml, p = 0.02). Within myocarditis cases, those administered the FV also had a lower rate of other irAEs when compared to unvaccinated cases (36 vs. 55% p = 0.10) including lower rates of pneumonitis (12 vs. 36%, p = 0.03). During follow-up (175 [IQR 89, 363] days), 47% of myocarditis cases experienced a MACE. Myocarditis cases who received the FV were a
AU  - Awadalla,M
AU  - Golden,DLA
AU  - Mahmood,SS
AU  - Alvi,RM
AU  - Mercaldo,ND
AU  - Hassan,MZO
AU  - Banerji,D
AU  - Rokicki,A
AU  - Mulligan,C
AU  - Murphy,SPT
AU  - Jones-O'Connor,M
AU  - Cohen,JV
AU  - Heinzerling,LM
AU  - Armanious,M
AU  - Sullivan,RJ
AU  - Damrongwatanasuk,R
AU  - Chen,CL
AU  - Gupta,D
AU  - Kirchberger,MC
AU  - Moslehi,JJ
AU  - Shah,SP
AU  - Ganatra,S
AU  - Thavendiranathan,P
AU  - Rizvi,MA
AU  - Sahni,G
AU  - Lyon,AR
AU  - Tocchetti,CG
AU  - Mercurio,V
AU  - Thuny,F
AU  - Ederhy,S
AU  - Mahmoudi,M
AU  - Lawrence,DP
AU  - Groarke,JD
AU  - Nohria,A
AU  - Fradley,MG
AU  - Reynolds,KL
AU  - Neilan,TG
DO  - 10.1186/s40425-019-0535-y
PY  - 2019///
SN  - 2051-1426
TI  - Influenza vaccination and myocarditis among patients receiving immune checkpoint inhibitors
T2  - Journal for ImmunoTherapy of Cancer
UR  - http://dx.doi.org/10.1186/s40425-019-0535-y
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000459434600001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - http://hdl.handle.net/10044/1/69843
VL  - 7
ER  -

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