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Treating Colorectal Cancer with Immunotherapy: Implications for Single Versus Combination Therapy

  • Basic Science Foundations in Colorectal Cancer (S Umar, Section Editor)
  • Published:
Current Colorectal Cancer Reports

Abstract

Purpose of Review

Colorectal cancer (CRC) is the second leading cause of cancer-associated deaths in the USA, 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 with single-agent immunotherapy or chemotherapy.

Summary

Given improved responsiveness and overall survival, there is a 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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Acknowledgments

The editors would like to thank Dr. Gopichand Pendurti for taking the time to review this article.

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Authors and Affiliations

  1. Department of Medicine, University of Kansas School of Medicine, Kansas City, KS, USA

    Sophiya Karki

  2. Department of Medicine, Division of Surgery, Kansas University Medical Center, Kansas City, KS, USA

    Shahid Umar

  3. Department of Medicine, Division of Medical Oncology, Kansas University Medical Center, 2650 Shawnee Mission Pkwy, Westwood, KS, 66205, USA

    Anup Kasi

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Karki, S., Umar, S. & Kasi, A. Treating Colorectal Cancer with Immunotherapy: Implications for Single Versus Combination Therapy. Curr Colorectal Cancer Rep 16, 107–117 (2020). https://doi.org/10.1007/s11888-020-00459-y

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