Nonoperative Management of dMMR/MSI-H Colorectal Cancer following Neoadjuvant Immunotherapy: A Narrative Review.

IF 1.2 4区医学 Q4 GASTROENTEROLOGY & HEPATOLOGY

Clinics in Colon and Rectal Surgery Pub Date : 2023-04-09 eCollection Date: 2023-11-01 DOI:10.1055/s-0043-1767703

Binyi Xiao, Jiehai Yu, Pei-Rong Ding

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引用次数: 0

Abstract

Immunotherapy with PD-1 blockade has achieved a great success in colorectal cancers (CRCs) with high microsatellite instability (MSI-H) and deficient mismatch repair (dMMR), and has become the first-line therapy in metastatic setting. Studies of neoadjuvant immunotherapy also report exciting results, showing high rates of clinical complete response (cCR) and pathological complete response. The high efficacy and long duration of response of immunotherapy has prompt attempts to adopt watch-and-wait strategy for patients achieving cCR following the treatment. Thankfully, the watch-and-wait approach has been proposed for nearly 20 years for patients undergoing chemoradiotherapy and has gained ground among patients as well as clinicians. In this narrative review, we combed through the available information on immunotherapy for CRC and on the watch-and-wait strategy in chemoradiotherapy, and looked forward to a future where neoadjuvant immunotherapy as a curative therapy would play a big part in the treatment of MSI-H/dMMR CRC.

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新辅助免疫治疗后dMMR/MSI-H结直肠癌癌症的非手术治疗：叙述性综述。

PD-1阻断的免疫治疗在具有高微卫星不稳定性（MSI-H）和缺陷错配修复（dMMR）的结直肠癌（CRC）中取得了巨大成功，并已成为转移环境中的一线治疗方法。新辅助免疫疗法的研究也报告了令人兴奋的结果，显示出高的临床完全反应（cCR）和病理完全反应率。免疫疗法的高效性和长期反应促使人们尝试对治疗后达到cCR的患者采取观察和等待策略。值得庆幸的是，这种观察和等待的方法已经为接受放化疗的患者提出了近20年，并在患者和临床医生中取得了进展。在这篇叙述性综述中，我们梳理了CRC免疫疗法和放化疗中的观察和等待策略的现有信息，并展望了新辅助免疫疗法作为一种治疗性疗法将在MSI-H/dMMR-CRC的治疗中发挥重要作用的未来。

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来源期刊

Clinics in Colon and Rectal Surgery GASTROENTEROLOGY & HEPATOLOGYSURGERY-SURGERY

CiteScore

2.60

自引率

7.10%

发文量

期刊介绍： Clinics in Colon and Rectal Surgery is a review journal that publishes topic-specific issues on diseases of the small bowel, colon, rectum, and anus. Designed for clinicians, researchers, and educators involved with diseases of the intestinal tract, the journal covers a broad spectrum of basic information, controversial clinical issues, and established and innovative diagnostic techniques. Issue topics comprehensively cover the entire specialty over a 3-4 year period, allowing the articles to serve as study material for educational programs and certifying examinations. The inclusion of research and clinical material also allows physicians to remain knowledgeable of current advances in the specialty.