Neoadjuvant immunotherapy: the "light of dawn" in patients with dMMR/MSI-H locally advanced colorectal cancer

doi:10.3877/cma.j.issn.2095-3224.2021.04.012

Abstract

Abstract:

Patients with locally advanced colorectal cancer (LACRC) have a higher risk of recurrence and metastasis. Neoadjuvant therapy can improve the prognosis to some extent. However, the sensitivity of mismatch repair defect (dMMR)/microsatellite instability-high (MSI-H) LACRC to neoadjuvant chemotherapy (chemoradiotherapy) is still low. The emergence of immunotherapy brings hope to these patients. Immunotherapy was listed as the top ten scientific progress by Science magazine in 2013. Based on the study of KEYNOTE-016 in 2015, it is confirmed that dMMR/MSI-H is a biomarker for the efficacy of immunotherapy, thus ushering in a novel era of immunotherapy in the field of colorectal cancer(CRC), and opening a new journey of precision immunotherapy in the era of precision medicine. Whether immunotherapy can be used as neoadjuvant treatment of LACRC has become a hot topic in clinic. The Dutch single-arm NICHE study published in Nature Medicine in 2020 has demonstrated shocking results, marking the opening of the door of neoadjuvant immunotherapy for CRC, opening up a new treatment path for patients with dMMR/MSI-H LACRC, and is expected to lead the development of a novel perspective of neoadjuvant therapy for different kinds of cancer.

Key words: Colorectal neoplasms, Locally advanced colorectal cancer, Neoadjuvant therapy, Immunotherapy, Mismatch repair deficiency, Microsatellite instability-high

Xuan Zhang, Tao Wu, Jinsha Li, Guoyu Li, Quan Li, Chao Dong, Ting Li, Renfang Yang, Yunfeng Li. Neoadjuvant immunotherapy: the "light of dawn" in patients with dMMR/MSI-H locally advanced colorectal cancer[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2021, 10(04): 404-408.

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References 28

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