An update on the use of immunotherapy in patients with colorectal cancer

Mike Nguyen, Sam Tipping Smith, Marissa Lam, Elizabeth Liow, Amy Davies, Hans Prenen, Eva Segelov

Research output: Contribution to journalReview ArticleResearchpeer-review

13 Citations (Scopus)

Abstract

Introduction: Colorectal cancer (CRC) is the third most common malignancy worldwide, with recent trends demonstrating increasing incidence amongst younger patients. Despite multiple treatment options, metastatic disease remains incurable. A new therapeutic strategy to harness the host immune system, specifically with immune checkpoint inhibitors, now has reported results from a number of clinical trials. Areas covered: This review will discuss in detail microsatellite instability (MSI) and other biomarkers for response to immunotherapy, summarize the pivotal clinical trials of immune checkpoint inhibitors in early-stage and metastatic MSI colorectal cancer, explore strategies to induce treatment responses in MSS CRC and highlight the emerging treatments and novel immune-based therapies under investigation. Expert opinion: Immunotherapy is now a standard of care for the proportion of CRC patients with MSI. While overall survival data are still awaited, the promise of profound and durable responses is highly anticipated. The lack of efficacy in MSS CRC is disappointing and strategies to convert these ‘cold’ tumors are needed. Further elucidation of optimal use of treatment sequences, combinations and novel agents will improve outcomes.

Original languageEnglish
Pages (from-to)291-304
Number of pages14
JournalExpert Review of Gastroenterology & Hepatology
Volume15
Issue number3
DOIs
Publication statusPublished - 2021

Keywords

  • Colorectal cancer
  • CTLA4
  • immune checkpoint inhibitor
  • immunotherapy
  • ipilimumab
  • microsatellite instability
  • mismatch repair
  • nivolumab
  • PDL1
  • pembrolizumab
  • rectal cancer

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