MEK and PD-L1 inhibition in colorectal cancer: a burning blaze turning into a flash in the pan
Mené dans 11 pays sur 363 patients atteints d'un cancer colorectal de stade métastatique, cet essai de phase III compare l'efficacité, du point de vue de la survie globale, et la toxicité de l'atézolizumab, avec ou sans cobimétinib, et du régorafénib en traitement de troisième ligne (durée médiane de suivi : 7,3 mois)
Immunotherapy has revolutionised the treatment landscape of a wide variety of tumours. In DNA mismatch repair-deficient or high microsatellite instability metastatic colorectal cancer, single-drug or double-drug immune checkpoint inhibition have shown notable activity in both the chemotherapy-naive and chemorefractory setting. Pembrolizumab, nivolumab, and nivolumab plus ipilimumab are now approved by the US Food and Drug Administration for patients with mismatch repair-deficient or high microsatellite instability metastatic colorectal cancer who have been previously treated with standard chemotherapy. By contrast, no benefit has been observed with these drugs in patients with DNA mismatch repair-proficient, low microsatellite instability, or microsatellite-stable tumours, who account for 95% of patients with metastatic colorectal cancer and are characterised by a low number of tumour mutations, neoantigens, and infiltrating immune effector cells.
The Lancet Oncology , commentaire, 2018