e14607 Background: Concerns have been raised over administration of influenza vaccination concurrent with immune checkpoint inhibitor therapy, specifically, implication in induction of Guillain-Barre syndrome. The aim of this study is to assess the safety and efficacy of influenza vaccination in patients undergoing anti-PD1 therapy. Methods: This is a prospective observational study evaluating the safety and efficacy of Afluria (Seqirus) in patients receiving anti-PD1 therapy. Antibody titers against common influenza A and B antigens were measured by a semi-quantitative ELISA on days 0, 45 and 90+ post vaccine administration to confirm anti-PD1 therapy did not interfere with anti-influenza humoral responses. Influenza infection, confirmed by rapid antigen testing, and influenza-related hospitalizations were reported among vaccinated patients. Safety was assessed using the FDA toxicity grading scale for clinical trials. Results: The acute humoral responses and subsequent IgG responses of the 28 patients included in this study are as follows in the table. IgM responses at 45 days to both influenza A and B common antigens were statistically significant (all P<0.05*). IgG response to common influenza B antigens was increased at day 45 ( P=0.001*). One of 28 patients contracted influenza B infection, confirmed by rapid antigen testing. There were no influenza-related hospitalizations. One patient had a grade 2 local adverse event (AE). A second patient had both a grade 2 local and a grade 2 systemic AE (myalgia). No grade 3/4 local or systemic AEs were reported. Conclusions: Administration of influenza vaccination concurrent with anti-PD1 therapy appeared safe in our study. No grade 3/4 local or systemic AEs were noted. Anti-PD1 therapy did not adversely affect anti-influenza humoral responses. Our data demonstrate that the increase in IgM reactivity to common influenza A and B antigens appears to be an immediate reaction to revaccination. Seroprotection can be inferred by documented infection in only one patient and absence of influenza related-hospitalizations. [Table: see text]

Introduction CONTACT is a national multidisciplinary study assessing the impact of the COVID-19 pandemic upon diagnostic and treatment pathways among patients with pancreatic ductal adenocarcinoma (PDAC). Methods The treatment of consecutive patients with newly diagnosed PDAC from a pre-COVID-19 pandemic cohort (07/01/2019-03/03/2019) were compared to a cohort diagnosed during the first wave of the UK pandemic (‘COVID’ cohort, 16/03/2020-10/05/2020), with 12-month follow-up. Results Among 984 patients (pre-COVID: n = 483, COVID: n = 501), the COVID cohort was less likely to receive staging investigations other than CT scanning (29.5% vs. 37.2%, p = 0.010). Among patients treated with curative intent, there was a reduction in the proportion of patients recommended surgery (54.5% vs. 76.6%, p = 0.001) and increase in the proportion recommended upfront chemotherapy (45.5% vs. 23.4%, p = 0.002). Among patients on a non-curative pathway, fewer patients were recommended (47.4% vs. 57.3%, p = 0.004) or received palliative anti-cancer therapy (20.5% vs. 26.5%, p = 0.045). Ultimately, fewer patients in the COVID cohort underwent surgical resection (6.4% vs. 9.3%, p = 0.036), whilst more patients received no anti-cancer treatment (69.3% vs. 59.2% p = 0.009). Despite these differences, there was no difference in median overall survival between the COVID and pre-COVID cohorts, (3.5 (IQR 2.8–4.1) vs. 4.4 (IQR 3.6–5.2) months, p = 0.093). Conclusion Pathways for patients with PDAC were significantly disrupted during the first wave of the COVID-19 pandemic, with fewer patients receiving standard treatments. However, no significant impact on survival was discerned.

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