Abstract
Colorectal cancer, especially liver metastasis, is still a challenge worldwide. Traditional treatment such as surgery, chemotherapy and radiotherapy have been difficult to be further advanced. We need to develop new treatment methods to further improve the poor prognosis of these patients. The emergence of immunotherapy has brought light to mCRC patients, especially those with dMMR. Based on several large trials, some drugs (pembrolizumab, nivolumab) have been approved by US Food and Drug Administration to treat the patients diagnosed with dMMR tumors. However, immunotherapy has reached a bottleneck for other MSS tumors, with low response rate and poor PFS and OS. Therefore, more clinical trials are underway toward mCRC patients, especially those with MSS. This review is intended to summarize the existing clinical trials to illustrate the development of immunotherapy in mCRC patients, and to provide a new thinking for the direction and experimental design of immunotherapy in the future.
Highlights
Colorectal cancer (CRC) has received a lot of attention and research due to its high incidence (10.2%) as well as high fatality rate (9.2%) among tumors worldwide [1]
In a retrospective study of 23 MSS or pMMR metastatic colorectal cancer (mCRC) treated with regorafenib plus antiPD-1 antibody, objective response rate (ORR) was 0% and disease control rate (DCR) was 78.3% (18/23), with the median Progression-free survival (PFS) of 3.1 months
Wang et al found that MSS CRC patients with no history of liver metastasis are more likely to benefit from this combination regorafenib plus antiPD-1 antibody [49]
Summary
Yongjiu Dai 1†, Wenhu Zhao 1†, Lei Yue 1†, Xinzheng Dai 1, Dawei Rong 1, Fan Wu 2, Jian Gu 1* and Xiaofeng Qian 1*. Colorectal cancer, especially liver metastasis, is still a challenge worldwide. Traditional treatment such as surgery, chemotherapy and radiotherapy have been difficult to be further advanced. We need to develop new treatment methods to further improve the poor prognosis of these patients. The emergence of immunotherapy has brought light to mCRC patients, especially those with dMMR. Immunotherapy has reached a bottleneck for other MSS tumors, with low response rate and poor PFS and OS. More clinical trials are underway toward mCRC patients, especially those with MSS. This review is intended to summarize the existing clinical trials to illustrate the development of immunotherapy in mCRC patients, and to provide a new thinking for the direction and experimental design of immunotherapy in the future
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