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SARS-CoV-2 Vaccine Immunogenicity in Patients with Gastrointestinal Cancer Receiving Systemic Anti-Cancer Therapy

Lau, David K., Aresu, Maria, Planche, Timothy, Tran, Amina, Lazaro-Alcausi, Retchel, Duncan, Julie, Kidd, Shannon, Cromarty, Susan, Begum, Ruwaida, Rana, Isma, and others. (2022) SARS-CoV-2 Vaccine Immunogenicity in Patients with Gastrointestinal Cancer Receiving Systemic Anti-Cancer Therapy. The Oncologist, 28 (1). e1-e8. ISSN 1083-7159. E-ISSN 1549-490X. (doi:10.1093/oncolo/oyac230) (KAR id:97877)


Introduction: Patients with gastrointestinal (GI) cancers have an increased risk of serious complications and death from SARS-CoV-2 infection. The immunogenicity of vaccines in patients with GI cancers receiving anti-cancer therapies is unclear. We conducted a prospective study to evaluate the prevalence of neutralizing antibodies in a cohort of GI cancer patients receiving chemotherapy following SARS-CoV-2 vaccination.

Materials and methods: Between September 2020 and April 2021, patients with cancer undergoing chemotherapy were enrolled. At baseline (day 0), days 28, 56, and 84, we assessed serum antibodies to SARS-CoV-2 spike (anti-S) and anti-nucleocapsid (anti-NP) and concomitantly assessed virus neutralization using a pseudovirus neutralization assay. Patients received either the Pfizer/BioNTech BNT162b2, or the Oxford/AstraZeneca ChAdOx1 vaccine.

Results: All 152 patients enrolled had a prior diagnosis of cancer; colorectal (n = 80, 52.6%), oesophagogastric (n = 38, 25.0%), and hepato pancreatic biliary (n = 22, 12.5%). Nearly all were receiving systemic anti-cancer therapy (99.3%). Of the 51 patients who did not receive a vaccination prior to, or during the study, 5 patients had detectable anti-NP antibodies. Ninety-nine patients received at least one dose of vaccine prior to, or during the study. Within 19 days following the first dose of vaccine, 30.0% had anti-S detected in serum which increased to 70.2% at days 20-39. In the 19 days following a second dose, anti-S positivity was 84.2% (32/38). However, pseudovirus neutralization titers (pVNT80) decreased from days 20 to 39.

Conclusion: Despite the immunosuppressive effects of chemotherapy, 2 doses of SARS-CoV-2 vaccines are able to elicit a protective immune response in patients' ongoing treatment for gastrointestinal cancers. Decreases in pseudoviral neutralization were observed after 20-39 days, re-affirming the current recommendation for vaccine booster doses.

Item Type: Article
DOI/Identification number: 10.1093/oncolo/oyac230
Uncontrolled keywords: SARS-CoV-2, vaccines, COVID-19, gastrointestinal cancer, pseudovirus, anti-spike, immunity, chemotherapy
Subjects: Q Science > QR Microbiology > QR355 Virology
Divisions: Divisions > Division of Natural Sciences > Medway School of Pharmacy
Funders: Wellcome Trust (
Royal Marsden Hospital (
Rosetrees Trust (
Depositing User: Nigel Temperton
Date Deposited: 08 Nov 2022 21:40 UTC
Last Modified: 17 Feb 2023 14:48 UTC
Resource URI: (The current URI for this page, for reference purposes)

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