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Impaired immunogenicity after vaccination for SARS-CoV-2 in patients with gastrointestinal cancer: does tumor entity

Malte Benedikt Monin1,2, Jens Gabriel Gorny1, Moritz Berger3

  • 1Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany.

Journal of Gastrointestinal Oncology
|July 12, 2023
PubMed
Abstract

Insights

Gastrointestinal cancer patients showed lower SARS-CoV-2 antibody levels after two vaccine doses, especially those undergoing treatment. Booster vaccination restored effective immunity in all patients, highlighting the need for vigilance against waning immunity and variants.

Area of Science:

  • Immunology
  • Oncology
  • Vaccinology

Background:

  • Analyzing SARS-CoV-2 immunogenicity in gastrointestinal (GI) cancer patients post-vaccination.
  • Assessing immune response in patients undergoing active anticancer therapy versus those in follow-up care.

Purpose of the Study:

  • To evaluate SARS-CoV-2 antibody and neutralization antibody titers after second and third vaccinations in GI cancer patients.
  • To identify specific cancer types (e.g., colorectal, hepatocellular) with potentially impaired vaccine responses.

Main Methods:

  • Prospective study of 125 GI cancer patients.
  • Measurement of SARS-CoV-2 anti-spike immunoglobulin G (IgG) and surrogate neutralization antibodies (NABs).

Main Results:

  • Significantly lower antibody titers observed in patients under active treatment compared to those in follow-up care after the second dose.
  • Colorectal cancer (CRC) patients showed low anti-spike IgG, while hepatocellular carcinoma (HCC) and pancreaticobiliary cancer patients had low NABs.
  • Booster vaccination led to effective antibody titers in all patients, with strong correlation between IgG and NABs.

Conclusions:

  • Active GI cancer patients exhibit impaired immunogenicity after initial SARS-CoV-2 vaccination, which is improved by booster doses.
  • Tumor type influences immune response, with CRC and HCC patients being particularly vulnerable.
  • Consideration of waning immunity and Omicron variant escape is crucial for this patient group.
Keywords:
SARS-CoV-2 immunogenicitySARS-CoV-2 surrogate neutralization antibodiesVaccination for SARS-CoV-2gastrointestinal cancervaccination failure

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