Frontiers in Immunology (Feb 2024)

Case report: Efficacy of immunotherapy as conversion therapy in dMMR/MSI-H colorectal cancer: a case series and review of the literature

  • María San-Román-Gil,
  • Iñigo Martínez-Delfrade,
  • Víctor Albarrán-Fernández,
  • Patricia Guerrero-Serrano,
  • Javier Pozas-Pérez,
  • Jesús Chamorro-Pérez,
  • Diana Rosero-Rodríguez,
  • Pilar Sotoca-Rubio,
  • Ana Maria Barrill-Corpa,
  • Víctor Alia-Navarro,
  • Carlos González-Merino,
  • Coral García-de-Quevedo-Suero,
  • Victoria López,
  • Ignacio Ruz-Caracuel,
  • Cristian Perna-Monroy,
  • Reyes Ferreiro-Monteagudo

DOI
https://doi.org/10.3389/fimmu.2024.1352262
Journal volume & issue
Vol. 15

Abstract

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Immunotherapy has demonstrated a role in the therapeutic landscape of a small subset of patients with colorectal carcinoma (CRC) that harbor a microsatellite instability (MSI-H) status due to a deficient DNA mismatch repair (dMMR) system. The remarkable responses to immune checkpoint inhibitors (ICIs) are now being tested in the neoadjuvant setting in localized CRC, where the dMMR/MSI-H status can be found in up to 15% of patients, with remarkable results obtained in NICHE2 and 3 trials, among others. This case series aims to report our experience at a tertiary center and provide a comprehensive analysis of the possible questions and challenges to overcome if ICIs were established as standard of care in a neoadjuvant setting, as well as the potential role they may have as conversion therapy not only in locoregional advanced CRC but also in oligometastatic disease.

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