Longitudinal Study of SARS-CoV-2 Vaccinations and Infections in Patients with Gastrointestinal Cancer: Stabilizing Immune Responses and Neutralizing Emerging Variants with Variant-Adapted Antigen Exposures

Q: How did GI cancer subtypes affect SARS-CoV-2 immune responses over time?

The study found that active GI cancer types weakened the ability of additional Omicron exposures to improve immune measures compared with other groups.

Q: Which patient subgroups showed reduced benefit from additional Omicron antigen exposures?

Improvement in IgG levels and Omicron neutralization was significantly less intense in patients with pancreaticobiliary neoplasms, underlying immunodeficiency, and/or those receiving conventional chemotherapy.

Sep 21, 2026

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This longitudinal study examined how active gastrointestinal (GI) cancer types shape immune responses to SARS-CoV-2, emphasizing neutralization of Omicron variants. Patients with GI cancer (n=168) were grouped by hepatocellular carcinoma, hepatic metastatic GI cancer, non-hepatic metastatic GI cancer, and controls with or without underlying liver disease. Humoral and cellular responses were measured before and after Omicron antigen exposure. Pre-Omicron humoral immunity waned after three antigen contacts, and Omicron neutralization was lower than wildtype, yet infections remained mild to moderate; additional exposures improved IgG and Omicron neutralization. The improvement was weaker in active GI cancer, notably pancreaticobiliary neoplasms, immunodeficiency, and conventional chemotherapy. Pre-Omicron immunity reduced severe courses, but initial Omicron antigen contact yielded reduced immune responses in these subgroups, supporting targeted booster strategies.

LanguageEnglish

CategoryResearch & Report

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Pages18

Reading Time45 min

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Abstract

Introduction

Article Longitudinal Study of SARS-CoV-2 Vaccinations and Infections in Patients with Gastrointestinal Cancer: Stabilizing Immune Responses and Neutralizing Emerging Variants with Variant-Adapted Antigen Exposures † Maria A. Gonzalez-Carmona 1,2,‡, Alina M. Schmitz 1,‡, Moritz Berger 3, Leona I. Baier 1, Jens G. Gorny 1, Farsaneh Sadeghlar 1,2, Thomas Anhalt 1,2, Xin Zhou 1,2, Taotao Zhou 1,2, Robert Mahn 1,2, Christian Möhring 1,2, Thomas Linnemann 4, Matthias Schmid 3, Christian P. Strassburg 1,2, Christoph Boesecke 1,5, Jürgen K. Rockstroh 1,5, Anna-Maria Eis-Hübinger 6 and Malte B. Monin 1,2,5,7, * Citation: Gonzalez-Carmona, M.A.; Schmitz, A.M.; Berger, M.; Baier, L.I.; Gorny, J.G.; Sadeghlar, F.; Anhalt, T.; Zhou, X.; Zhou, T.; Mahn, R.; et al. Longitudinal Study of SARS-CoV-2 Vaccinations and Infections in Patients with Gastrointestinal Cancer: Stabilizing Immune Responses and Neutralizing Emerging Variants with Variant-Adapted Antigen Exposures. Int. J. Mol. Sci. 2024, 25, 13613 . [https://doi.org/10.3390/ijms252413613](https://doi.org/10.3390/ijms252413613) Academic Editor: Marta De Angelis Received: 15 November 2024 Revised: 11 December 2024 Accepted: 14 December 2024 Published: 19 December 2024 Copyright: © 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) . 1 Department of Internal Medicine I, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany 2 Centre for Integrated Oncology (CIO), Aachen, Bonn, Cologne, Düsseldorf (ABCD), Partner-Site Bonn, Venusberg-Campus 1, 53127 Bonn, Germany 3 Institute for Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany 4 Institute of Experimental Haematology and Transfusion Medicine, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany 5 German Centre for Infection Research (DZIF), Partner-Site Cologne-Bonn, Venusberg-Campus 1, 53127 Bonn, Germany 6 Institute of Virology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany 7 Infektionsmedizinisches Centrum Hamburg (ICH), Glockengießerwall 1, 20095 Hamburg, Germany * Correspondence: malte_[benedikt.monin@ukbonn.de](benedikt.monin@ukbonn.de) † This work was presented as an oral presentation at the Jahrestagung der Deutschen, Österreichischen und Schweizerischen Gesellschaften für Hämatologie und Medizinische Onkologie 2024 in Basel, Switzerland from 11 to 14 October 2024 . ‡ These authors contributed equally to this work. Abstract: This longitudinal study examined how active gastrointestinal (GI) cancer types affect immune responses to SARS-CoV-2, focusing on the ability to neutralize the Omicron variants. Patients with GI cancer (n = 168) were categorized into those with hepatocellular carcinoma, hepatic metastatic GI cancer, non-hepatic metastatic GI cancer, and two control groups of patients with and without underlying liver diseases. Humoral and cellular immune responses were evaluated before and after Omicron antigen exposures. In the pre-Omicron era, humoral SARS-CoV-2 immunity decreased after three antigen contacts without further antigen exposure. While Omicron neutralization was significantly lower than wildtype neutralization (p < 0.01), Omicron infections were yet mild to moderate. Additional Omicron exposures improved IgG levels (p < 0.01) and Omicron neutralization (p < 0.01) . However, this effect was significantly less intense in patients with active GI cancer, particularly in patients with pancreaticobiliary neoplasms (PBN; p = 0.04), with underlying immunodeficiency (p = 0.05), and/or under conventional chemotherapy (p = 0.05) . Pre-Omicron SARS-CoV-2 immunity prevented severe clinical

FAQs

How did GI cancer subtypes affect SARS-CoV-2 immune responses over time?

The study found that active GI cancer types weakened the ability of additional Omicron exposures to improve immune measures compared with other groups.

What were the key differences between Omicron and wildtype neutralization?

Omicron neutralization was significantly lower than wildtype neutralization, although Omicron infections were generally mild to moderate.

Which patient subgroups showed reduced benefit from additional Omicron antigen exposures?

Improvement in IgG levels and Omicron neutralization was significantly less intense in patients with pancreaticobiliary neoplasms, underlying immunodeficiency, and/or those receiving conventional chemotherapy.

Sep 21, 2026

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