Is a 61-year-old male with a history of brain cancer eligible for Arexvy (generic name) and if so, what is the recommended dose?

Arexvy Eligibility and Dosing for 61-Year-Old Male with History of Brain Cancer

Yes, a 61-year-old male with a history of brain cancer is eligible for Arexvy, administered as a single 0.5 mL intramuscular injection. 1, 2

Eligibility Criteria

Arexvy is FDA-approved for adults aged 60 years and older to prevent lower respiratory tract illness caused by respiratory syncytial virus (RSV), with no specific exclusions for patients with a history of cancer. 1, 2

• The vaccine contains recombinant RSV glycoprotein F stabilized in the prefusion conformation and is indicated for all adults ≥60 years of age 1
• Clinical trials demonstrating the vaccine's safety and efficacy included older adults, and there are no contraindications listed for patients with prior malignancies 1, 2
• The patient's age of 61 years places him squarely within the approved age range for Arexvy administration 1, 2

Cancer History Considerations

A history of brain cancer does not constitute a contraindication to Arexvy vaccination. 1, 2

• Clinical trial eligibility criteria for cancer treatments have evolved to be more inclusive of patients with prior cancers, recognizing that another primary cancer diagnosis does not necessarily interfere with safety or efficacy of unrelated therapies 3
• The vaccine is designed to prevent RSV infection, and there is no biological mechanism by which a history of brain cancer would increase risk or decrease efficacy 1, 2
• Patients with brain cancer history who have completed treatment and are in follow-up are at standard risk for RSV complications given their age 1, 2

Dosing Regimen

The recommended dose is a single 0.5 mL intramuscular injection. 1

• Arexvy provides approximately 83% protection against RSV lower respiratory tract illness in adults aged 60 and older 1
• Protection appears to maintain effectiveness for up to two RSV seasons after a single dose 1
• No dose adjustments are required based on cancer history or other comorbidities 1, 2

Expected Adverse Effects

The most common adverse events are mild to moderate and self-limited. 1

• Injection site pain is the most frequently reported adverse event 1
• Systemic symptoms include fatigue, myalgia, headache, and arthralgia 1
• These adverse events were generally mild to moderate in severity in clinical trials 1
• No increased risk of adverse events has been identified in patients with prior malignancies 1, 2

Clinical Considerations

Vaccination should be administered during RSV season (typically fall through spring) for optimal protection. 1, 2

• Older adults, including those with cancer history, are at disproportionately high risk for RSV-related hospitalizations and death 1, 2
• RSV causes 6,000-10,000 deaths and 60,000-160,000 hospitalizations annually among adults aged 65 and older in the United States 2
• The vaccine represents a significant advancement in preventive care for this vulnerable population 1, 2

Common Pitfalls to Avoid

Do not unnecessarily delay vaccination due to cancer history alone. 1, 2

• There is no requirement for oncology clearance prior to RSV vaccination in patients with prior brain cancer who have completed treatment 1, 2
• The vaccine should not be withheld based solely on cancer history, as this represents an important preventive measure for a high-risk age group 1, 2
• If the patient is currently receiving active cancer treatment, verify that there are no specific immunosuppressive concerns, though this is not a standard contraindication 1, 2