Adverse effects when getting a flu shot while under the ICI treatment

[Olga]

We always advocated the seasonal flu shot for our patients.
This year with Ivan being under Keytruda treatment, there is a question if there might be a drugs interaction as they both - Keytruda and flu shot - p;ay in the same field. So we started to investigate before getting a seasonal flu shot. And I have to say I am puzzled - despite being marketed for few years now, the safety of influenza vaccination during the use of checkpoint inhibitors is not defined. The clinical trials are ongoing, there are no results yet.
but.
There are few articles that report increased number of the severe adverse events (AE) when the patient under the ICI treatment got a flu shot.
1.Immune response and adverse events to influenza vaccine in cancer patients undergoing PD-1 blockade.
http://ascopubs.org/doi/abs/10.1200/JCO ... ppl.e14523
2. Severe Pneumonitis in Patient with Kidney Cancer Using Nivolumab after Influenza Vaccine - A Case Report
http://pubs.sciepub.com/ajmcr/5/6/5/index.html
so I have no clue as how to evaluate the possible risks of having and not having a flu shot while under the immune checkpoint inhibitor treatment.
Please anyone who had a flu shot while under Keytruda, Opdivo etc. - comment here?

[D.ap]

Thank you Olga for the articles.
I hope to hear a response from our oncologist .
A very important point to research .

[Olga]

I do not expect the oncologist being able to provide a meaningful advice here - they base their guidance on the studies and it seems that there are no studies completed at the moment.
The problem that it seems that even people that were having mild ICI related adverse effect, may develop the catastrophic level reactions to immuno checkpoint inhibitors (grade 3 or 4) when vaccinated during the ICI treatment...it is scary and the patient may end by being taken off ICI treatment.

[D.ap]

Hello again Olga and Ivan
So I guess the question is if a person gambles on
1.Getting the vaccine and having possible side effects in the lungs as a low grade reaction ( non live , antibody creating after 2weeks after shot)
And or very high grade inflammatory reaction , life threatening results ?

2.Or maybe getting the flu and riding that virus thru it’s course with whatever is needed pain relievers. Lung infections ( antibiotics )
3. Or maybe not even contracting the flu virus as -

My understanding the shot covers what a board of health professional deem the possiblity of locals contracted in a patients area?
Lots of hand washing , staying out of large crowds can go along ways in preventiion ?

Maybe a case by case ( ie high tumor load in lungs verses low tumor load )

[D.ap]

Also look what’s included in a shot : o

https://www.healthline.com/health/cold- ... ngredients

[D.ap]

Found an article from a Swiss study



“Influenza vaccine may cause exaggerated immune response in patients on cancer immunotherapy”

https://www.pharmaceutical-journal.com/ ... Pass=false