[HTML][HTML] Immunotherapy in colorectal cancer: rationale, challenges and potential

K Ganesh, ZK Stadler, A Cercek… - Nature reviews …, 2019 - nature.com
K Ganesh, ZK Stadler, A Cercek, RB Mendelsohn, J Shia, NH Segal, LA Diaz Jr
Nature reviews Gastroenterology & hepatology, 2019nature.com
Following initial successes in melanoma treatment, immunotherapy has rapidly become
established as a major treatment modality for multiple types of solid cancers, including a
subset of colorectal cancers (CRCs). Two programmed cell death 1 (PD1)-blocking
antibodies, pembrolizumab and nivolumab, have shown efficacy in patients with metastatic
CRC that is mismatch-repair-deficient and microsatellite instability-high (dMMR–MSI-H), and
have been granted accelerated FDA approval. In contrast to most other treatments for …
Abstract
Following initial successes in melanoma treatment, immunotherapy has rapidly become established as a major treatment modality for multiple types of solid cancers, including a subset of colorectal cancers (CRCs). Two programmed cell death 1 (PD1)-blocking antibodies, pembrolizumab and nivolumab, have shown efficacy in patients with metastatic CRC that is mismatch-repair-deficient and microsatellite instability-high (dMMR–MSI-H), and have been granted accelerated FDA approval. In contrast to most other treatments for metastatic cancer, immunotherapy achieves long-term durable remission in a subset of patients, highlighting the tremendous promise of immunotherapy in treating dMMR–MSI-H metastatic CRC. Here, we review the clinical development of immune checkpoint inhibition in CRC leading to regulatory approvals for the treatment of dMMR–MSI-H CRC. We focus on new advances in expanding the efficacy of immunotherapy to early-stage CRC and CRC that is mismatch-repair-proficient and has low microsatellite instability (pMMR–MSI-L) and discuss emerging approaches for targeting the immune microenvironment, which might complement immune checkpoint inhibition.
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