Treating Colorectal Cancer with Immunotherapy: Implications for Single versus Combination Therapy.

Q3 Medicine

Current Colorectal Cancer Reports Pub Date : 2020-10-01 Epub Date: 2020-08-20 DOI:10.1007/s11888-020-00459-y

Sophiya Karki, Shahid Umar, Anup Kasi

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Abstract

Purpose of review: Colorectal cancer (CRC) is the second leading cause of cancer-associated deaths in the United States, with most metastatic cases subsequently turning refractory to standard chemotherapy. One of the promising current interventions is immunotherapy that relies on harnessing the body's immune mechanisms to kill the cancer cells. The aim of this review is to highlight the implications of single versus combination immunotherapy and identify the molecular features and mutations that enhance or deter responsiveness.

Recent findings: Based on current findings, responsiveness is associated with deficiency of mismatch repair (dMMR) genes or presence of microsatellite instability (MSI-high), with high immunoscore and tumor-mutational burden contributing to better efficacy while BRAF mutation conferring no significant effect. Combination immunotherapy demonstrates better efficacy in treating MSI-high CRC compared to single agent immunotherapy or chemotherapy.

Summary: Given improved responsiveness and overall survival, there is potential for immunotherapy to change the standard of care for metastatic CRC. Furthermore, stratifying the patients by their molecular features and mutation status is critical for establishing care.

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用免疫疗法治疗结直肠癌：单一疗法对联合疗法的影响。

综述目的：在美国，结直肠癌（CRC）是导致癌症相关死亡的第二大原因，大多数转移性病例随后会对标准化疗产生耐药性。免疫疗法是目前最有前途的干预措施之一，它依靠利用人体的免疫机制来杀死癌细胞。本综述旨在强调单一免疫疗法与联合免疫疗法的意义，并确定增强或抑制反应性的分子特征和突变：根据目前的研究结果，反应性与错配修复（dMMR）基因缺陷或存在微卫星不稳定性（MSI-高）有关，高免疫评分和肿瘤突变负荷有助于提高疗效，而BRAF突变则无明显影响。与单药免疫疗法或化疗相比，联合免疫疗法在治疗 MSI 高的 CRC 方面疗效更好。此外，根据患者的分子特征和突变状态对其进行分层对于制定治疗方案至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Colorectal Cancer Reports ONCOLOGY-

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期刊介绍： This journal aims to review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of colorectal cancer. By providing clear, insightful, balanced contributions by international experts, the journal intends to serve all those involved in the care of those with the disease. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as current and emerging therapeutic approaches and the molecular basis of disease. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.