Deficient Immune Response following SARS-CoV-2 Vaccination in Patients with Hepatobiliary Carcinoma: A Forgotten, Vulnerable Group of Patients.

Data on immune response rates following vaccination for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in patients with hepatobiliary carcinoma (HBC) are rare. However, impaired immunogenicity must be expected due to the combination of chronic liver diseases (CLDs) with malignancy and anticancer treatment. In this prospective, longitudinal study, 101 patients were included, of whom 59 were patients with HBC under anticancer treatment. A cohort of patients with a past medical history of gastrointestinal cancer, of whom 28.6% had HBC without detectable active tumor disease having been off therapy for at least 12 months, served as control. Levels of SARS-CoV-2 anti-spike IgG, surrogate neutralization antibodies (sNABs), and cellular immune responses were compared. In uni- and multivariable subgroup analyses, risk factors for impaired immunogenicity were regarded. Data on rates and clinical courses of SARS-CoV-2 infections were documented. In patients with HBC under active treatment, levels of SARS-CoV-2 anti-spike IgG were significantly lower (2.55 log Patients with active HBC showed significantly impaired immune response rates to basic vaccinations for SARS-CoV-2, especially under chemotherapy, independent of underlying cirrhotic or non-cirrhotic CLD. Although booster vaccinations balanced differences, waning immunity was observed over time and should be monitored for further recommendations. Our data help clinicians decide on individual additional booster vaccinations and/or passive immunization or antiviral treatment in patients with HBC getting infected with SARS-CoV-2.

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© 2023 The Author(s). Published by S. Karger AG, Basel.

Déclaration de conflit d'intérêts

M.A.G.C. has contributed to advisory boards for Roche, Eisai, BMS, MSD, and AZ. C.B. received honoraria for lectures and/or consultancies from AbbVie, Gilead, Janssen, MSD, and ViiV as well as funding from Dt. Leberstiftung, DZIF, Hector Stiftung, and NEAT ID. M.B.M. received travel expenses and honoraria from Gilead, Pfizer, and Virology Education. JKR 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. None of the other authors have any potential conflicts (financial, professional, or personal) that are relevant to the manuscript.