Neoadjuvant Immunotherapy-Based Systemic Treatment in MMR-Deficient or MSI-High Rectal Cancer: Case Series
| Autor: | Arta M. Monjazeb, Kit Tam, Madison McKenny, Wissam J. Halabi, Jun Gong, Rahel Demisse, Ryan Louie, Jingran Ji, Farshid Dayyani, Edward J. Kim, Marwan Fakih, James Liu, Cathy Eng, Sepideh Gholami, May Cho, Neha Damle, Leslie G. Oesterich |
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| Rok vydání: | 2020 |
| Předmět: |
Oncology
Male medicine.medical_specialty Organoplatinum Compounds Colorectal cancer medicine.medical_treatment Leucovorin Ipilimumab Pembrolizumab Antibodies Monoclonal Humanized FOLFOX Neoplastic Syndromes Hereditary Internal medicine Antineoplastic Combined Chemotherapy Protocols Medicine Humans Neoadjuvant therapy business.industry Brain Neoplasms Rectal Neoplasms Chemoradiotherapy medicine.disease Neoadjuvant Therapy Radiation therapy Nivolumab Female Fluorouracil Immunotherapy business Colorectal Neoplasms medicine.drug |
| Zdroj: | Journal of the National Comprehensive Cancer Network : JNCCN. 18(7) |
| ISSN: | 1540-1413 |
| Popis: | Treatment options for locally advanced rectal cancer have continued to consist largely of chemotherapy, chemoradiation, and/or surgical resection. For patients who are unable to undergo these therapeutic modalities or who do not to experience a response to them, treatment options are limited. We report 3 cases of mismatch repair–deficient (dMMR) locally advanced adenocarcinoma of the rectum that showed significant response with neoadjuvant immunotherapy–based systemic treatment. The first patient was not eligible for standard therapy because of a history of radiotherapy to the prostate with concurrent comorbidities and therefore received single-agent pembrolizumab. The second patient did not respond to total neoadjuvant chemoradiation and subsequently received combined nivolumab and ipilimumab. The third patient had a known family history of Lynch syndrome and presented with locally advanced rectal cancer and a baseline carcinoembryonic antigen level of 1,566 ng/mL. She was treated using neoadjuvant pembrolizumab and FOLFOX (folinic acid, fluorouracil, oxaliplatin). In this small series, we suggest that single-agent and combined-modality neoadjuvant immunotherapy/chemotherapy appear to be safe and effective treatment options for patients with (dMMR) locally advanced rectal cancer. Our findings encourage further studies to investigate the role of neoadjuvant immunotherapy as a viable treatment strategy in this population. |
| Databáze: | OpenAIRE |
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