Yuegang Li1,2, Chi Xue1, Ziming Gao1, Kai Li1, Huimian Xu1, Zhi Zhu3. 1. Department of Surgical Oncology, The First Affiliated Hospital of China Medical University, Shenyang, 110001, People's Republic of China. 2. Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Hebei Cancer Hospital, Chinese Academy of Medical Sciences, Langfang, 065001, China. 3. Department of Surgical Oncology, The First Affiliated Hospital of China Medical University, Shenyang, 110001, People's Republic of China. zhuzhi@cmu.edu.cn.
Abstract
BACKGROUND: Although neoadjuvant immunotherapy is being widely studied, there is no consensus on its efficacy in microsatellite-stable (MSS) or mismatch repair proficient (pMMR) colorectal cancer (CRC). This meta-analysis aimed to evaluate studies on neoadjuvant immunotherapy for advanced CRC to assess its efficacy and provide new clinical guidelines. METHODS: We searched literature databases to identify studies that assessed the efficacy of neoadjuvant immunotherapy in advanced CRC. The outcomes evaluated were pathological complete response (pCR), major pathological response (MPR), R0 resection, and anal preservation rates. Heterogeneity among the included studies was assessed by sensitivity analysis, and publication bias was evaluated using Begg and Egger tests. RESULTS: Eleven articles were included in the analysis. The pCR, MPR, R0 resection, and anal preservation rates reported in these studies were 39 and 49, 97, and 76%, respectively. The MSI-H and MSS groups had pooled pCR rates of 70 and 24%, respectively. The pCR rates for the induction, consolidation, and concurrent immuno-chemoradiotherapy (CRT) subgroups were 43, 33, and 27%, respectively, and those for the single and double immunotherapy subgroups were 34 and 40%, respectively. CONCLUSION: Neoadjuvant immunotherapy combined with CRT is effective in treating MSI-H/dMMR advanced CRC. It could also be a new first-line therapeutic option for MSS/pMMR advanced CRC.
BACKGROUND: Although neoadjuvant immunotherapy is being widely studied, there is no consensus on its efficacy in microsatellite-stable (MSS) or mismatch repair proficient (pMMR) colorectal cancer (CRC). This meta-analysis aimed to evaluate studies on neoadjuvant immunotherapy for advanced CRC to assess its efficacy and provide new clinical guidelines. METHODS: We searched literature databases to identify studies that assessed the efficacy of neoadjuvant immunotherapy in advanced CRC. The outcomes evaluated were pathological complete response (pCR), major pathological response (MPR), R0 resection, and anal preservation rates. Heterogeneity among the included studies was assessed by sensitivity analysis, and publication bias was evaluated using Begg and Egger tests. RESULTS: Eleven articles were included in the analysis. The pCR, MPR, R0 resection, and anal preservation rates reported in these studies were 39 and 49, 97, and 76%, respectively. The MSI-H and MSS groups had pooled pCR rates of 70 and 24%, respectively. The pCR rates for the induction, consolidation, and concurrent immuno-chemoradiotherapy (CRT) subgroups were 43, 33, and 27%, respectively, and those for the single and double immunotherapy subgroups were 34 and 40%, respectively. CONCLUSION: Neoadjuvant immunotherapy combined with CRT is effective in treating MSI-H/dMMR advanced CRC. It could also be a new first-line therapeutic option for MSS/pMMR advanced CRC.
Authors: Luis A Diaz; Kai-Keen Shiu; Tae-Won Kim; Benny Vittrup Jensen; Lars Henrik Jensen; Cornelis Punt; Denis Smith; Rocio Garcia-Carbonero; Manuel Benavides; Peter Gibbs; Christelle de la Fourchardiere; Fernando Rivera; Elena Elez; Dung T Le; Takayuki Yoshino; Wen Yan Zhong; David Fogelman; Patricia Marinello; Thierry Andre Journal: Lancet Oncol Date: 2022-04-12 Impact factor: 54.433
Authors: Lorenzo F Fanchi; Krijn K Dijkstra; José G Van den Berg; Emile E Voest; John B Haanen; Myriam Chalabi; Arend G Aalbers; Karolina Sikorska; Marta Lopez-Yurda; Cecile Grootscholten; Geerard L Beets; Petur Snaebjornsson; Monique Maas; Marjolijn Mertz; Vivien Veninga; Gergana Bounova; Annegien Broeks; Regina G Beets-Tan; Thomas R de Wijkerslooth; Anja U van Lent; Hendrik A Marsman; Elvira Nuijten; Niels F Kok; Maria Kuiper; Wieke H Verbeek; Marleen Kok; Monique E Van Leerdam; Ton N Schumacher Journal: Nat Med Date: 2020-04-06 Impact factor: 53.440
Authors: Osama E Rahma; Greg Yothers; Theodore S Hong; Marcia M Russell; Y Nancy You; William Parker; Samuel A Jacobs; Linda H Colangelo; Peter C Lucas; Marc J Gollub; William A Hall; Lisa A Kachnic; Namrata Vijayvergia; Mark A O'Rourke; Bryan A Faller; Richard K Valicenti; Tracey E Schefter; Sagila George; Radhika Kainthla; Philip J Stella; Elin Sigurdson; Norman Wolmark; Thomas J George Journal: JAMA Oncol Date: 2021-08-01 Impact factor: 33.006