Abstract
To date, immune checkpoint blockade (ICB) immunotherapy has become one of promise strategies in the management of patients with unresectable or metastatic colorectal cancer (CRC). However, clinical observations showed that not all the patients responded equally to ICBs, certain group of CRC patients with microsatellite-instability-low (MSI-L) phenotype was not sensitive to ICB immunotherapy. In addition, some primary responders might lose their sensitivity and become resistant to ICBs overtime. To obtain a better response rate and therapeutic efficacy, considerable attempts have been made toward to a precision medicine algorithm. Studies showed that multiple strategies based on the patient’s individual condition might improve the response and therapeutic efficacy to ICBs. Therefore, we focused on and discussed precision strategies and perspectives e.g., how to early define candidates who will benefit from ICB immunotherapy prior treatment, overcome the primary and acquired resistance and improve the therapeutic response to ICBs in CRC patients with different microsatellite-instability statuses within the context of precision medicine algorithm in this review.
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