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SARS-CoV-2 vaccination in patients with GI and hepatobiliary carcinoma: a call for booster vaccination
  1. Malte Benedikt Monin1,2,
  2. Leona Baier1,
  3. Moritz Berger3,
  4. Jens Gabriel Gorny1,
  5. Taotao Zhou1,
  6. Robert Mahn1,
  7. Farsaneh Sadeghlar1,
  8. Christian Möhring1,
  9. Kathrin van Bremen1,2,
  10. Christoph Boesecke1,2,
  11. Jürgen Rockstroh1,2,
  12. Christian Strassburg1,
  13. Anna-Maria Eis-Hübinger4,
  14. Maria Agnes Gonzalez-Carmona1
  1. 1Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany
  2. 2German Centre for Infection Research (DZIF), Partner-site Cologne-Bonn, Bonn, Germany
  3. 3Institute for Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, Bonn, Germany
  4. 4Institute of Virology, University Hospital Bonn, Bonn, Germany
  1. Correspondence to Dr Malte Benedikt Monin, University Hospital Bonn, 53127 Bonn, Germany; malte_benedikt.monin{at}

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Bollipo et al1 presented recommendations for SARS-CoV-2 infections in patients with chronic liver diseases (CLDs). Since their publication, at least three SARS-CoV-2 vaccinations are recommended for all persons regardless of comorbidities.2 Cancer and CLD are associated with impaired immune responses to SARS-CoV-2 vaccines.3–6 However, patients with GI cancer, especially with hepatobilary carcinoma (HBC), are under-represented in published studies.

In this prospective, longitudinal study, 120 patients with GI cancer, including 32.5% HBC, participated (table 1). Patients under anticancer therapy were analysed compared with patients with GI cancer in follow-up care (≥1 year off anticancer therapy). We present profound data on humoral response rates (SARS-CoV-2 antispike and surrogate neutralisation antibodies (sNAB) using SARS-CoV-2 IgG II Quant chemiluminescent microparticle immunoassay (Abbott Laboratories) and cPass SARS-CoV-2 Neutralization Antibody Detection Kit (GenScript), respectively). Of note, the ELISA analysing levels of sNAB is limited when it comes to current variants of concern (VOCs; BA.1, BA.2, BA.4 and BA.5). Therefore, rates of infections are more important. Cellular response rates were not considered. Linear mixed regression models were used to compare levels of total (log10 transformed) and neutralising antibodies.

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Table 1

Patientbaseline characteristics

Four weeks after second vaccination, levels of SARS-CoV-2 antispike IgG were significantly lower in patients with active GI cancer (2.48 log10 binding antibody unit (BAU)/mL; 95% CI 2.28 to 2.68; p<0.01) and HBC (2.52 log10 BAU/mL; 95% CI 2.25 to 2.78; p<0.01) compared with patients …

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  • Contributors MBM: planning study, data interpreting, drafting and editing of manuscript, final approval, submitting the manuscript, responsible for the overall content as guarantor; LB: data collecting and final approval; MB: data interpreting, drafting of images, revision of manuscript and final approval; JGG: data collecting and interpreting, drafting of tables/ images, editing of manuscript and final approval; TZ: data collecting and final approval; RM: data collecting and final approval; FS: planning study, data collecting and final approval; CM, KvB and CS: final approval; CB and JR: revision and final approval; A-ME-H: data collecting, revision and final approval; MAG-C: study planning, editing and final approval and responsible for the overall content as guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests CB received honoraria for lectures and/ or consultancies from AbbVie, Gilead, Janssen, MSD, ViiV and funding from Dt. Leberstiftung, DZIF, Hector Stiftung, NEAT ID. MAG-C has contributed to advisory boards for Roche, Eisai, BMS, MSD and AZ. MBM received travel expenses and honoraria from Gilead and Virology Education. GJR received travel expenses and honoraria from Gilead. JR has received honoraria for lectures and/or consultancies from Abivax, Galapagos, Gilead, Merck, Janssen, Theratechnologies and ViiV. However, these activities have no potential conflicts of interest with the manuscript.

  • Provenance and peer review Not commissioned; externally peer reviewed.