Immunotherapy for Colorectal Cancer: A Review of Current and Novel Therapeutic Approaches
A partir d'une revue de la littérature, cette étude analyse l'efficacité des immunothérapies chez des patients atteints d'un cancer colorectal
Colorectal cancer (CRC) remains a leading cause of cancer-related deaths in the US. While immunotherapy has dramatically changed the landscape of treatment for many advanced cancers, the benefit in CRC has thus far been limited to those with MSI-H/dMMR tumors. Recent studies in the refractory CRC setting have led to US Food and Drug Administration approvals for pembrolizumab as well as nivolumab (with or without ipilimumab) for tumors harboring a MSI-H/dMMR molecular profile. Several randomized controlled trials are underway to move immunotherapy into the frontline for metastatic cancer (with or without chemotherapy) and the adjuvant setting. Awareness of these studies is critical given the relatively low incidence (approximately 3-5%) of MSI-H/dMMR in advanced/metastatic CRC to support study completion, as the results could be potentially practice changing. The real challenge in this disease is related to demonstrating the benefit of immunotherapy for the vast majority of patients with CRC not harboring MSI-H/dMMR. Given the rapid pace of scientific changes, this article provides a narrative review regarding the current landscape of immunotherapy for CRC. Particular attention is paid to the currently available data that informs today’s clinical practice along with upcoming randomized controlled trials (RCTs) that may soon dramatically change the treatment landscape for CRC.