title: Cancer patients treated with sunitinib or sorafenib have sufficient antibody and cellular immune responses to warrant influenza vaccination.
abstract: OBJECTIVE
  The tyrosine kinase inhibitors sorafenib and sunitinib have efficacy in several types of cancer. Recent studies indicate that these agents affect the immune system. The way it affects the immune response to influenza vaccination is unknown. The aim of this study was to elucidate the specific immune response to seasonal flu vaccination in cancer patients treated with sunitinib or sorafenib.
  
  
  METHODS
  Sunitinib- or sorafenib-treated cancer patients were vaccinated against seasonal influenza with an inactivated vaccine. Healthy controls and patients with metastatic renal cell cancer (mRCC) without systemic treatment (nontreated mRCC controls) were included for comparison. Antibody responses were measured at baseline, day 8, and day 22 by a standard hemagglutination inhibition assay and cellular T-cell responses at baseline and day 8 by proliferation assay and secretion of cytokines.
  
  
  RESULTS
  Forty subjects were enrolled: 16 patients treated with sunitinib, 6 patients with sorafenib, 7 nontreated mRCC controls, and 11 healthy controls. All patients treated with sunitinib and sorafenib developed seroprotection rates comparable with controls. Functional T-cell reactivity was observed in all groups, except for patients treated with sorafenib who showed a decreased proliferation rate and IFN-γ/IL-2 production and increased IL-10 compared with healthy controls.
  
  
  CONCLUSIONS
  We conclude that influenza vaccination should be recommended to cancer patients treated with sunitinib or sorafenib.
authors.affiliation: Department of Medical Oncology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
authors.forename: Sasja F
authors.initials: SF
authors.lastname: Mulder
authors.forename: Joannes F M
authors.initials: JF
authors.lastname: Jacobs
authors.forename: Michel A M
authors.initials: MA
authors.lastname: Olde Nordkamp
authors.forename: Joep M D
authors.initials: JM
authors.lastname: Galama
authors.forename: Ingrid M E
authors.initials: IM
authors.lastname: Desar
authors.forename: Ruurd
authors.initials: R
authors.lastname: Torensma
authors.forename: Steven
authors.initials: S
authors.lastname: Teerenstra
authors.forename: Peter F A
authors.initials: PF
authors.lastname: Mulders
authors.forename: Kris C P
authors.initials: KC
authors.lastname: Vissers
authors.forename: Cornelis J A
authors.initials: CJ
authors.lastname: Punt
authors.forename: I Jolanda M
authors.initials: IJ
authors.lastname: de Vries
authors.forename: Carla M L
authors.initials: CM
authors.lastname: van Herpen
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001557:Benzenesulfonates / Q000627:therapeutic use*; D002292:Carcinoma, Renal Cell / Q000188:drug therapy / Q000276:immunology; D005260:Female; D006801:Humans; D007111:Immunity, Cellular / Q000276:immunology; D056724:Immunity, Humoral / Q000276:immunology; D007211:Indoles / Q000627:therapeutic use*; D007252:Influenza Vaccines / Q000276:immunology*; D007251:Influenza, Human / Q000276:immunology / Q000517:prevention & control*; D007680:Kidney Neoplasms / Q000188:drug therapy / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009536:Niacinamide / Q000031:analogs & derivatives; D010671:Phenylurea Compounds; D011725:Pyridines / Q000627:therapeutic use*; D011758:Pyrroles / Q000627:therapeutic use*; D000077157:Sorafenib; D000077210:Sunitinib; D013997:Time Factors; D014611:Vaccination
chemical_list: D000970:Antineoplastic Agents; D001557:Benzenesulfonates; D007211:Indoles; D007252:Influenza Vaccines; D010671:Phenylurea Compounds; D011725:Pyridines; D011758:Pyrroles; D009536:Niacinamide; D000077157:Sorafenib; D000077210:Sunitinib