Good Tumor Response to Chemoradioimmunotherapy in dMMR/MSI-H Advanced Colorectal Cancer: A Case Series
| العنوان: | Good Tumor Response to Chemoradioimmunotherapy in dMMR/MSI-H Advanced Colorectal Cancer: A Case Series |
|---|---|
| المؤلفون: | Chengjing Zhou, Ting Jiang, Yajie Xiao, Qiaoxuan Wang, Zhifan Zeng, Peiqiang Cai, Yongtian Zhao, Zhikun Zhao, Dongfang Wu, Hanqing Lin, Chao Sun, Rong Zhang, Weiwei Xiao, Yuanhong Gao |
| المصدر: | Frontiers in Immunology, Vol 12 (2021) Frontiers in Immunology |
| بيانات النشر: | Frontiers Media S.A., 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Adult, Male, programmed cell death protein 1 inhibitor, Brain Neoplasms, Immunology, High-Throughput Nucleotide Sequencing, colorectal cancer, Middle Aged, Radioimmunotherapy, RC581-607, chemotherapy, Neoplastic Syndromes, Hereditary, Mutation, Humans, Immunology and Allergy, Female, Microsatellite Instability, immunotherapy, Immunologic diseases. Allergy, Colorectal Neoplasms, Immune Checkpoint Inhibitors, radiotherapy, Original Research |
| الوصف: | PurposeImmune checkpoint blockade has led to a significant improvement of patient survival in metastatic colorectal cancer (CRC) with DNA mismatch repair-deficiency (dMMR)/microsatellite instability-high (MSI-H). However, not all these patients are sensitive to monoimmunotherapy. We firstly presented a case series of advanced dMMR/MSI-H CRCs treating with PD-1 inhibitor-based chemoradioimmunotherapy (CRIT).Methods and MaterialsWe assessed the short-term efficacy and safety of CRIT in advanced dMMR/MSI-H CRCs, and also did next-generation sequencing (NGS) assays.ResultsOur analysis included five advanced dMMR/MSI-H CRCs who have received toripalimab-based CRIT. Toripalimab was given 240mg every three weeks, and the radiation dose was 45-50 gray in 25 fractions. Chemotherapy regimens consisted of CAPOX in three patients, capecitabine in one patient, and mFOLFOX6 in one patient. Initially, two patients displayed complete response (CR), and three patients achieved partial response (PR) on imaging findings. Afterwards, one PR patient was confirmed pathological complete response after surgery, leading to three CR cases in total. Hematological toxicity was the most common adverse effect, and only two patients developed mild immune-related adverse effects besides. All the treatment-related adverse events were under control. Based on the NGS results, the median intratumor heterogeneity was 0.19 (range 0-0.957), which was less in CR patients than PR patients (P = 0.019). Genetic mutations at DNA damage repair genes and the JAK1 gene were also observed.ConclusionsFor advanced dMMR/MSI-H CRC, anti-PD-1 based CRIT is effective and safe. Further studies are required to better clarify the potential role and mechanism of CRIT as a viable therapeutic strategy in this population. |
| اللغة: | English |
| تدمد: | 1664-3224 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::0cdd6450bae40f60a3da00908d4dfbf7Test https://www.frontiersin.org/articles/10.3389/fimmu.2021.784336/fullTest |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....0cdd6450bae40f60a3da00908d4dfbf7 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 16643224 |
|---|