Photo Credit: Mohammed Haneefa Nizamudeen
The following is a summary of “Introducing Neoadjuvant Immunotherapy for Colorectal Cancer: Advancing the Frontier,” published in the January 2025 issue of Surgery by Orhan et al.
Immunotherapy, including checkpoint inhibitors, has revolutionized cancer care but shows variable effectiveness in colorectal cancer (CRC) due to factors like tumor microenvironment, genetic changes, and immune response diversity.
Researchers conducted a retrospective study to evaluate current and future applications of neoadjuvant immunotherapy in people diagnosed with localized CRC.
They reviewed existing studies to summarize the major types of immunotherapies used to treat localized CRC, analyzed approaches for predicting treatment response using biomarkers and radiologic assessments, and explored potential clinical implications and challenges of neoadjuvant immunotherapy.
The results showed that immune checkpoint inhibitors are most effective for individuals with CRC with deficient mismatch repair (dMMR) status or polymerase epsilon (POLE) mutations. A smaller group with proficient mismatch repair (pMMR) status also responded to treatment. Neoadjuvant immunotherapy demonstrated encouraging complete response rates, potentially supporting organ-preserving strategies such as watch-and-wait approaches.
They concluded that identifying MMR status at diagnosis was essential for tailoring neoadjuvant immunotherapy in people with localized CRC.
