Sergio Cifuentes Canaval: Exciting Advances in Immunotherapy for Colon Cancer
Sergio Cifuentes Canaval, Cancer Research Project Manager at CENEIT Mexico, shared on LinkedIn:
“Exciting Advances in Immunotherapy for Colon Cancer
Key Findings from Neoadjuvant Nivolumab + Ipilimumab in dMMR Colon Cancer (NICHE 2):
– Prevalence: dMMR tumors found in 10-15% of nonmetastatic colon cancer patients.
– Study Focus: Evaluated neoadjuvant immunotherapy (nivolumab + ipilimumab) in previously untreated, locally advanced dMMR colon cancer.
Results:
– Timely Surgery: 98% (113/115) of patients underwent surgery on time (within ≤2-week delay).
– Safety: Only 4% (5 patients) experienced grade 3 or 4 immune-related adverse events.
Pathological Response:
- 98% had a pathological response.
- 95% achieved a major pathological response (≤10% residual viable tumor).
- 68% had a pathological complete response (0% residual viable tumor).
Follow-Up: No recurrences with a median follow-up of 26 months.
Here are some insights and opinions:
Safety and Efficacy: The NICHE-2 study demonstrates impressive safety outcomes with 98% of patients undergoing timely surgery and only 4% experiencing grade 3 or 4 immune-related adverse events. This indicates that neoadjuvant nivolumab plus ipilimumab is generally well-tolerated in patients with dMMR colon cancer.
Pathological Response: The study shows a remarkable pathological response, with almost 100% of patients achieving some degree of pathological response, including 68% achieving a complete pathological response. These findings suggest a robust anti-tumor effect of the combination therapy.
Long-term Outcomes: With a median follow-up of 26 months and no reported recurrences, the study highlights potential durable benefits of neoadjuvant immunotherapy in this patient population.
Practice Implications: The results imply a potential shift in clinical practice towards incorporating neoadjuvant immunotherapy for dMMR colon cancer. This approach could lead to rethinking traditional treatment paradigms, possibly bypassing traditional phase III randomized trials in favor of expedited adoption due to ethical considerations and significant efficacy observed..
Overall, the NICHE-2 study represents a pivotal advancement in the treatment landscape of dMMR colon cancer, emphasizing the potential of immunotherapy in the neoadjuvant setting and paving the way for further refinements in treatment strategies for different molecular subtypes of colon cancer.”