Multiple Myeloma Clinical Trial
Official title:
Study of High-dose Influenza Vaccine Efficacy by Repeated Dosing IN Gammopathy Patients (SHIVERING 2)
The investigators' hypothesis is that the administration of Fluzone® High-Dose with booster to all patients with monoclonal gammopathies (irrespective of age) will lead to seroconversion rates exceeding 50% and more importantly, will reduce influenza-related morbidity, reduce interruptions in cancer therapy and may reduce disease progression at the end of the flu season
Influenza is a major cause of morbidity in the US. Patients with monoclonal gammopathies are
known to have increased risk of developing influenza. Furthermore, several of the medications
(such as proteasome inhibitors), commonly used to treat these tumors, are known to further
increase the risk of these tumors. Seasonal influenza vaccination has been shown to reduce
influenza related morbidity and is approved for routine prophylaxis in US. In 2009, Fluzone®
high- dose vaccine was FDA approved in 2009 for adults aged 65 and older based on the data
regarding higher rates of seroprotection (defined as hemagglutination antibody inhibition
(HAI) titer of 40 or higher).
In this study, the investigators will administer Fluzone® High-Dose vaccine with a planned
booster to patients with monoclonal gammopathies irrespective of age versus a standard of
care control group. Primary endpoint is composite of documented influenza infection rate and
disease progression (as defined by International Myeloma Working Group criteria) at the end
of the flu season. Based on the background data, the investigators expect a higher rate of
success in the experimental arm. As such, the investigators power for success rates of 90%
and 70% in the experimental and control arms, respectively.
The investigators will also analyze several secondary endpoints including rates of influenza
related morbidity, the analysis of humoral and cellular immune response to these vaccines and
the rate of disease control (defined as lack of disease progression by standard international
myeloma working group criteria).
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