
Immunotherapy for Rectal Cancer: Types, Success Rate, Side Effects and More
Immunotherapy has emerged as a promising treatment option for rectal cancer, particularly in advanced and microsatellite instability-high (MSI-H) cases. By harnessing the body’s immune system to target and destroy cancer cells, immunotherapy offers a novel approach beyond traditional chemotherapy and radiation.
This article explores the main types of immunotherapy used in rectal cancer, evaluates current success rates, outlines potential side effects, and highlights ongoing research shaping the future of rectal cancer management.
What Is Immunotherapy for Rectal Cancer?
Immunotherapy is a type of cancer treatment that helps the body’s own immune system recognize and destroy cancer cells. Unlike traditional treatments like surgery, which physically removes tumors, or chemotherapy, which uses drugs to kill rapidly dividing cells, immunotherapy boosts the immune system’s ability to detect and attack cancer. This is especially important in rectal cancer cases where the immune system might not initially recognize tumor cells as dangerous.
One of the most effective forms of immunotherapy for rectal cancer, particularly for tumors with high microsatellite instability (MSI-H), is the use of immune checkpoint inhibitors. These are drugs that block proteins such as PD-1 or PD-L1, which act as brakes on immune cells. In many cancers, tumor cells use PD-L1 to hide from the immune system by binding to PD-1 receptors on T cells. When drugs block this interaction, T cells can recognize and attack cancer cells more effectively.
A groundbreaking study published in the New England Journal of Medicine (Cercek et al., 2022) showed that the anti–PD-1 drug dostarlimab produced a 100% clinical complete response rate in a small group of 12 patients with mismatchrepair–deficient (dMMR) rectal cancer. All patients avoided surgery, chemotherapy, and radiation, and none had disease progression at a median follow-up of 12 months. This study highlights the remarkable potential of immunotherapy in selected rectal cancer patients.
What Are the Types of Immunotherapy for Rectal Cancer?
Immunotherapy for rectal cancer primarily includes immune checkpoint inhibitors such as pembrolizumab (Keytruda) and nivolumab, which target the PD-1 pathway. In some cases, a dual immunotherapy approach combining nivolumabwith ipilimumab (a CTLA-4 inhibitor) is also used, especially in patients with microsatellite instability-high (MSI-H) or mismatch repair-deficient (dMMR) tumors. These therapies represent the main types of immunotherapy currently employed in the management of rectal cancer.
Checkpoint Inhibitors for Rectal Cancer
Immune checkpoint inhibitors have transformed the treatment landscape of multiple malignancies, including a subset of rectal cancers. Chief among these are Keytruda (pembrolizumab) and Opdivo (nivolumab), monoclonal antibodies that target the PD-1/PD-L1 axis, restoring T-cell-mediated immune surveillance against tumor cells. Under physiological conditions, programmed cell death protein 1 (PD-1) on T cells binds to its ligands, PD-L1 or PD-L2, which are expressed on tumor cells and antigen-presenting cells. This interaction transmits an inhibitory signal, leading to T cell exhaustion and immune evasion by cancer cells.
Checkpoint inhibitors like pembrolizumab and nivolumab are IgG4 monoclonal antibodies that bind to PD-1, preventing its interaction with PD-L1 and PD-L2. This blockade effectively “releases the brakes” on the immune system, allowing cytotoxic T cells to recognize and eliminate cancer cells more effectively. This mechanism is particularly effective in tumors with deficient mismatch repair (dMMR) or microsatellite instability-high (MSI-H), which harbor a high mutational burden and present more neoantigens to the immune system. In June 2020, the U.S. Food and Drug Administration (FDA) granted tissue/site-agnostic approval to pembrolizumab for adult and pediatric patients with unresectable or metastatic MSI-H/dMMR solid tumors, including colorectal and rectal cancers, based on durable responses seen in multiple tumor types (FDA, 2020). Nivolumab was also approved for MSI-H/dMMR metastatic colorectal cancer that had progressed following standard chemotherapy (fluoropyrimidine, oxaliplatin, and irinotecan). Though not yet specifically labeled for non-metastatic rectal cancer, both drugs are used off-label or within trials in localized cases with dMMR/MSI-H phenotype.
According to the NCCN Guidelines for Rectal Cancer (Version 1.2025), checkpoint inhibitors are recommended for rectal cancer patients with dMMR/MSI-H or POLE/POLD1 ultra-hypermutated phenotype, including:
- Locally unresectable or medically inoperable disease
- Suspected or proven metastatic synchronous adenocarcinoma
- Resectable metachronous metastases (REC-14 to REC-17)
A landmark study by Cercek et al. (2022) published in The New England Journal of Medicine demonstrated complete clinical response in 100% of the first 12 patients with locally advanced dMMR rectal cancer treated with dostarlimab, a PD-1 inhibitor, without the need for chemoradiation or surgery. In metastatic settings, data from the KEYNOTE-177 trialsupported pembrolizumab as first-line therapy in dMMR/MSI-H metastatic colorectal cancer, showing significantly longer progression-free survival compared to chemotherapy (16.5 vs. 8.2 months) Similarly, the CheckMate 142 studyevaluated nivolumab ± ipilimumab in dMMR/MSI-H metastatic colorectal cancer and reported high objective response rates (31–55%) and durable disease control in previously treated patients .
Perhaps the most striking evidence for the power of checkpoint inhibition in rectal cancer comes from a recent Phase II study of dostarlimab (Cercek et al., 2022), which investigated its use in patients with locally advanced dMMR rectal cancer. In this trial, 12 patients received dostarlimab without any concurrent chemotherapy, radiation, or surgery. Remarkably, all 12 patients achieved a complete clinical response, with no evidence of tumor on imaging, endoscopy, or biopsy. None of the patients required further treatment, and none experienced disease recurrence at a median follow-up of 12 months. Importantly, no significant adverse events were reported. These findings suggest that in select patients, checkpoint inhibitors may eliminate the need for traditional therapies and their associated toxicities.
Dual Immunotherapy for Rectal Cancer
In recent years, immunotherapy has emerged as a transformative modality in the management of colorectal cancers, particularly in tumors exhibiting high immunogenicity. Among these, mismatch repair-deficient (dMMR) or microsatellite instability-high (MSI-H) rectal cancers represent a distinct molecular subtype that is especially responsive to immune checkpoint inhibitors. These tumors harbor a high mutational burden, producing neoantigens that make them more visible to the immune system, and thus more amenable to immune-based therapies. A particularly promising strategy involves dual immune checkpoint blockade—the combination of nivolumab, an anti-PD-1 antibody, and ipilimumab, an anti-CTLA-4 antibody. This combination leverages two complementary mechanisms of T-cell activation: PD-1 blockade enhances T-cell activity in the tumor microenvironment, while CTLA-4 inhibition promotes T-cell priming and expansion in lymphoid organs. When used together, they can produce a broader and more durable immune response than monotherapy alone.
The efficacy of this approach was highlighted in the CheckMate 142 trial, a multicenter phase II study that evaluated nivolumab in combination with ipilimumab in patients with previously treated dMMR/MSI-H metastatic colorectal cancer, a group that includes patients with rectal primaries. In this cohort, the combination therapy demonstrated an objective response rate (ORR) of 55%, a disease control rate approaching 80–85%, and 12-month progression-free survival and overall survival rates of 71% and 85%, respectively. Notably, some patients achieved complete radiographic responses, and the safety profile was considered manageable, with the most common grade ≥3 adverse events being fatigue, diarrhea, and elevated liver enzymes (Overman et al., 2018; Overman et al., 2021).
Building on this evidence, the National Comprehensive Cancer Network (NCCN) has included nivolumab plus ipilimumab among the recommended systemic therapy options for advanced or metastatic dMMR/MSI-H rectal cancer in its 2025 Clinical Practice Guidelines. This combination is particularly considered when intensive therapy is not feasible due to concerns about toxicity. In such scenarios, the dual checkpoint blockade offers a non-cytotoxic yet effective alternative, offering long-lasting disease control in a subset of patients with favorable molecular profiles (NCCN Guidelines for Rectal Cancer, Version 1.2025, REC-F 4 of 13).
What Are the Side Effects of Immunotherapy for Rectal Cancer?
Immunotherapy for Rectal Cancer can result in a range of side effects that vary in severity. While some side effects are common and generally manageable, others can be serious and require close monitoring.
Common Side Effects
Immunotherapy, particularly with checkpoint inhibitors like nivolumab and ipilimumab, has revolutionized the treatment of certain cancers, including advanced or recurrent rectal cancer. However, these therapies can lead to a range of side effects, with skin rash, fatigue, and gastrointestinal issues being among the most frequently reported. (According American Cancer Society)
- Skin Rash: Skin-related side effects are common with checkpoint inhibitors. Patients may experience rashes, pruritus (itching), and vitiligo (loss of skin pigmentation). The severity can vary from mild redness to more pronounced dermatitis.Management typically involves topical corticosteroids and antihistamines for mild cases. In more severe instances, systemic corticosteroids may be required, and treatment may need to be paused or discontinued based on the severity.
- Fatigue: Fatigue is one of the most commonly reported side effects of checkpoint inhibitors. Patients often describe a persistent sense of tiredness that can interfere with daily activities. Management strategies include regular physical activity, energy conservation techniques, and addressing underlying factors such as anemia or thyroid dysfunction.
- Gastrointestinal Issues: Gastrointestinal (GI) side effects, particularly diarrhea and colitis, are notable concerns with checkpoint inhibitors. Diarrhea can range from mild to severe, with some patients developing colitis characterized by abdominal pain, increased stool frequency, and blood in the stool. According to the American Cancer Society, diarrhea is a common side effect of these therapies. Management involves prompt evaluation, with mild cases treated using anti-diarrheal agents and dietary modifications. More severe cases may necessitate corticosteroids or immunosuppressive agents like infliximab. Early intervention is crucial to prevent complications such as dehydration or bowel perforation.
- Prevalence and Clinical Trial Data: The incidence of these side effects can vary depending on the specific agent and treatment regimen. For instance, in studies involving ipilimumab, skin-related side effects were observed in a significant proportion of patients, with rash and pruritus being among the most common. Fatigue was also frequently reported, and GI events like diarrhea occurred in a notable percentage of patients. Combination therapies, such as nivolumab plus ipilimumab, tend to have a higher incidence of adverse effects compared to monotherapy, necessitating vigilant monitoring and management.
Managing the side effects of immunotherapy requires a proactive and multidisciplinary approach to ensure patient safety and optimize treatment outcomes. Regular monitoring plays a crucial role in detecting early signs of adverse reactions, allowing healthcare providers to intervene before complications escalate. Educating patients about potential side effects and encouraging them to report new or worsening symptoms promptly can significantly improve the timeliness and effectiveness of care.
Supportive treatments such as anti-diarrheal medications, corticosteroids, and antihistamines are often used to manage symptoms, along with appropriate lifestyle adjustments tailored to each patient’s needs. In cases where side effects become severe, adjustments to the immunotherapy regimen—such as dose modification or temporary discontinuation—may be necessary to protect the patient’s well-being. Through vigilant observation, open communication, and targeted supportive care, clinicians can help patients better tolerate treatment, remain on therapy longer, and ultimately achieve improved clinical outcomes.
Severe Side Effects
Immunotherapy, particularly through the use of immune checkpoint inhibitors (ICIs) like nivolumab and ipilimumab, has revolutionized the treatment of various cancers, including advanced rectal cancer. However, these therapies can lead to significant immune-related adverse events (irAEs), such as autoimmune disorders and colitis, which require careful monitoring and management.
ICIs function by enhancing the immune system’s ability to detect and attack cancer cells. However, this heightened immune activity can sometimes lead to the immune system attacking healthy tissues, resulting in autoimmune disorders.Commonly affected organs include the skin, endocrine glands, lungs, and the gastrointestinal tract. The severity of these irAEs can range from mild to life-threatening, necessitating prompt recognition and intervention.
Effective management of serious irAEs involves several key steps
- Regular Monitoring: Patients should undergo routine assessments to detect early signs of irAEs. This includes monitoring for symptoms such as diarrhea, abdominal pain, and changes in bowel habits, which may indicate colitis.
- Prompt Intervention: At the onset of mild symptoms, ICIs may be temporarily withheld, and supportive care initiated. For moderate to severe symptoms, corticosteroids like prednisone are administered to reduce inflammation. If symptoms persist or worsen, additional immunosuppressive agents such as infliximab or vedolizumab may be considered.
- Patient Education: Educating patients about potential side effects and encouraging them to report new or worsening symptoms promptly is crucial for early detection and management.
By implementing vigilant monitoring and timely intervention strategies, healthcare providers can effectively manage serious side effects associated with immunotherapy, thereby improving patient outcomes and maintaining the delicate balance between treatment efficacy and safety.
Read more about radiotherapy for Rectal Cancer
New Treatments for Rectal Cancer
Recent advancements in immunotherapy have introduced a new era in the treatment of rectal cancer, particularly for patients with specific molecular profiles such as microsatellite instability-high (MSI-H) or mismatch repair-deficient (dMMR) tumors. The most prominent forms of immunotherapy under investigation and clinical use include:
- Next-generation checkpoint inhibitors, including agents targeting novel pathways like LAG-3, TIM-3, and TIGIT, which aim to overcome resistance to standard ICIs.
- Personalized neoantigen-based vaccines, designed to elicit immune responses tailored to individual tumor mutations.
- Adoptive T-cell therapies, such as tumor-infiltrating lymphocyte (TIL) therapy and engineered T-cell receptor (TCR) therapies, which redirect patient T-cells to recognize cancer-specific targets.
- Bispecific antibodies and immune modulators, which engage T-cells with tumor cells more directly or modulate the tumor microenvironment to enhance immune activity.
These approaches reflect a growing shift toward precision immuno-oncology, offering new hope for patients with advanced or treatment-resistant rectal cancer.
mRNA Vaccines for Rectal Cancer
Messenger RNA (mRNA) vaccines have emerged as a promising therapeutic strategy in oncology, aiming to train the immune system to recognize and attack cancer cells effectively. In the context of rectal cancer, these vaccines are designed to elicit robust immune responses against tumor-specific antigens, potentially improving patient outcomes.
- Mechanism of mRNA Cancer Vaccines: mRNA vaccines function by delivering synthetic mRNA encoding tumor-associated antigens (TAAs) or tumor-specific antigens (TSAs) into the body’s antigen-presenting cells (APCs). Once inside, the mRNA is translated into the corresponding protein, which is then presented on the cell surface via major histocompatibility complexes (MHC). This presentation activates the immune system, prompting it to recognize and destroy cancer cells expressing these antigens.
PMC - Advancements in mRNA Vaccines for Rectal Cancer: While mRNA vaccine research has predominantly focused on cancers like melanoma and non-small cell lung cancer, recent efforts have extended into colorectal cancers, including rectal cancer. A notable example is the development of personalized mRNA vaccines targeting KRAS mutations, which are prevalent in colorectal cancers. For instance, a phase 1 trial investigated an mRNA vaccine targeting KRAS mutations in patients with pancreatic and colorectal cancers. The study reported that 84% of patients exhibited the desired immune response, with a corresponding reduction in circulating tumor DNA levels, indicating a potential therapeutic benefit.
Combination Therapies with Immunotherapy for Rectal Cancer
Combining immunotherapy with traditional treatments such as chemotherapy and radiation therapy has emerged as a promising strategy to enhance therapeutic efficacy in rectal cancer. This approach leverages the synergistic effects of these modalities to improve patient outcomes.
- Combination of Chemoradiotherapy and Immunotherapy: Neoadjuvant chemoradiotherapy (nCRT) is a standard treatment for locally advanced rectal cancer (LARC). Recent studies have explored the addition of immunotherapy to this regimen, particularly in microsatellite stable (MSS) rectal cancers, which typically exhibit limited responsiveness to immunotherapy alone. A systematic review and meta-analysis by Wu et al. analyzed data from eight studies involving 204 patients with MSS-type LARC who received nCRT combined with immunotherapy. The integrated analysis revealed a pathological complete response (pCR) rate of 33%, a sphincter preservation rate of 86%, and an R0 resection rate of 83%. These findings suggest that the addition of immunotherapy to nCRT can significantly enhance short-term efficacy in MSS-type LARC, improving pCR and sphincter preservation rates.
- Radiotherapy and Immunotherapy Synergy: The combination of radiotherapy and immunotherapy has shown promise in enhancing therapeutic efficacy and reducing recurrence rates. Radiotherapy can modulate the tumor microenvironment, increasing tumor antigen presentation and enhancing immune system recognition of cancer cells. This creates a more favorable setting for immunotherapeutic agents to exert their effects. A review by Gong et al. discussed how this combination can overcome tumor immune tolerance mechanisms, thereby improving treatment outcomes.
- Ongoing Clinical Trials: Several clinical trials are currently investigating the efficacy of combining immunotherapy with chemoradiotherapy in rectal cancer. For example, the National Cancer Institute (NCI) lists ongoing studies exploring the addition of monoclonal antibodies, such as nivolumab, to standard chemoradiotherapy regimens. These trials aim to assess whether the integration of immunotherapy can enhance tumor response rates and improve survival outcomes.
How Is Immunotherapy Administered for Rectal Cancer?
Immunotherapy for rectal cancer is typically administered through intravenous (IV) infusions, delivered directly into the bloodstream at a hospital or cancer treatment center. Patients usually receive these infusions every 2 to 3 weeks, depending on the specific drug and treatment plan. A single session may last anywhere from 30 minutes to several hours, especially when combining drugs like nivolumab and ipilimumab.
During treatment, patients sit or lie comfortably while the medication is infused. They are monitored for any immediate side effects, such as chills, rash, or fatigue. After treatment, most patients can go home the same day. Side effects, if they occur, may happen shortly after or even days later and can include tiredness, mild fever, or digestive issues. Care teams closely monitor the patient’s response through regular check-ups and blood tests to assess both effectiveness and safety.
What Should Patients Expect During Treatment?
During immunotherapy treatment, patients can expect a routine that typically begins with IV infusions at a clinic or hospital, often every 2 to 3 weeks. The infusion process is usually straightforward—patients are seated comfortably while the medication is administered over 30 minutes to a few hours. Nurses monitor for any immediate reactions like rash, fever, or breathing changes.
After treatment, patients return home but remain under close observation. Side effects—such as fatigue, diarrhea, or skin irritation—can develop days later, so ongoing communication with the care team is essential. Regular blood tests and imaging help track the body’s response and detect complications early.
Follow-up care includes routine health checks, and patients are often encouraged to make lifestyle adjustments—like eating well, staying active, and managing stress—to support their immune system and overall well-being. These steps help maximize the treatment’s benefits while minimizing risks.
How Long Does It Take to See Results from Immunotherapy?
Patients starting immunotherapy should know that results often take time—it may be several weeks to a few monthsbefore clear signs of improvement appear. The timeline varies depending on the type of immunotherapy, the patient’s overall health, and how their cancer responds.
Unlike chemotherapy, which may cause rapid tumor shrinkage, immunotherapy works by gradually stimulating the immune system, so the benefits can take longer to become visible. Some patients might feel better early on, while others may not notice changes until after multiple treatment cycles. Regular scans and blood tests help doctors assess progress, and in some cases, even initial tumor growth may be followed by later shrinkage—a response pattern known as pseudoprogression.
What Are the Costs of Immunotherapy for Rectal Cancer?
Immunotherapy can be financially demanding for rectal cancer patients, with treatment costs ranging from $10,000 to over $100,000 per year, depending on the drug, duration, and whether it’s used alone or in combination. For example, checkpoint inhibitors like nivolumab or pembrolizumab can cost $10,000–$15,000 per infusion, and combination therapies like nivolumab + ipilimumab are typically even more expensive.
Most private insurance plans and Medicare cover FDA-approved immunotherapy for eligible cancer types, but patients may still face significant out-of-pocket costs, including copays, deductibles, and uncovered services. It’s important to verify coverage in advance with both the oncology team and the insurer. To help ease the burden, many drug manufacturers and cancer organizations offer financial assistance programs. Programs like the Patient Advocate Foundation, CancerCare, and pharmaceutical-sponsored assistance (e.g., Bristol Myers Squibb for nivolumab) can help with drug costs or travel support. Hospitals often have financial counselors who guide patients through these options.
How Does Immunotherapy Compare to Other Treatments for Rectal Cancer?
The treatment landscape for rectal cancer encompasses various modalities, including surgery, chemotherapy, radiation therapy, and immunotherapy. Each approach offers distinct benefits and challenges concerning effectiveness, side effects, and long-term survival outcomes. Recent studies have also explored the potential of combination therapies to enhance patient prognosis.
- Surgery: Surgical resection remains the cornerstone for localized rectal cancer, particularly in early stages.According to Miller et al. in CA: A Cancer Journal for Clinicians, the 5-year survival rate exceeds 90% for stage I rectal cancer patients undergoing surgery . However, the survival rate declines significantly in advanced stages, underscoring the need for adjunctive treatments.
- Chemotherapy: Chemotherapy is often employed in conjunction with surgery to address micrometastatic disease.Standard regimens, such as FOLFOX (5-fluorouracil, leucovorin, and oxaliplatin), have demonstrated 5-year survival rates ranging from 50% to 75% in stage III microsatellite stable (MSS) colon cancer patients, as reported by OncoDaily . While effective, chemotherapy is associated with side effects like neuropathy and neutropenia.
- Radiation Therapy: Radiation therapy, particularly in the neoadjuvant setting, aims to reduce tumor size and facilitate surgical resection. A clinical practice guideline published in Practical Radiation Oncology notes that neoadjuvant chemotherapy with FOLFOX, when compared to chemoradiotherapy, resulted in significantly greater grade 3 to 4 toxicities, especially neuropathy and neutropenia .
- Immunotherapy: Immunotherapy has shown promise, especially in patients with mismatch repair-deficient (dMMR) or microsatellite instability-high (MSI-H) tumors. A notable study conducted at Memorial Sloan Kettering Cancer Center demonstrated that all participants with MSI-H rectal cancer experienced complete tumor regression following treatment with the PD-1 inhibitor dostarlimab, eliminating the need for surgery, radiation, or chemotherapy .
- Combination Therapies: Combining immunotherapy with traditional treatments is an area of active investigation.A study led by UCLA Health researchers found that integrating experimental immunotherapy drugs with chemotherapy significantly improved progression-free survival (6.2 months vs. 2.1 months) and overall survival (19.7 months vs. 9.5 months) compared to regorafenib alone in metastatic colorectal cancer patients . Additionally, a systematic review and meta-analysis by Wu et al. in Frontiers in Immunology analyzed data from patients with MSS-type locally advanced rectal cancer (LARC) who received neoadjuvant chemoradiotherapy combined with immunotherapy. The analysis revealed a pathological complete response (pCR) rate of 33%, a sphincter preservation rate of 86%, and an R0 resection rate of 83%, suggesting enhanced short-term efficacy with the addition of immunotherapy .
Can All Rectal Cancer Patients Receive Immunotherapy?
Eligibility for immunotherapy in rectal cancer primarily depends on specific tumor biomarkers. Patients whose tumors are MSI-H (microsatellite instability-high) or dMMR (deficient mismatch repair) are strong candidates, as these features predict a high likelihood of response to immune checkpoint inhibitors like nivolumab or pembrolizumab. These tumors tend to have a high mutation burden, making them more recognizable to the immune system.
In contrast, patients with MSS (microsatellite stable) tumors typically do not respond well to immunotherapy, as these cancers lack the immunogenic features needed to trigger an effective immune response. For MSS patients, eligibility may still be considered in clinical trials or when combined with treatments like chemoradiotherapy.
Other factors influencing eligibility include the stage of the cancer, previous treatments, and overall health status, all of which are assessed by the oncology team to determine the most appropriate therapeutic approach.
What Research Is Being Done on Immunotherapy for Rectal Cancer?
Recent advancements in immunotherapy have significantly influenced the treatment landscape for rectal cancer. Notably, a study at Memorial Sloan Kettering Cancer Center demonstrated that all participants with mismatch repair-deficient (dMMR) rectal cancer experienced complete tumor regression following treatment with the PD-1 inhibitor dostarlimab, eliminating the need for surgery, radiation, or chemotherapy. In another study, the TORCH trial evaluated the integration of a PD-1 inhibitor with total neoadjuvant therapy in patients with microsatellite stable (MSS) locally advanced rectal cancer. The trial aimed to assess improvements in complete responses and the feasibility of a watch-and-wait strategy.
Furthermore, a clinical trial sponsored by the Cancer Research Institute is investigating a combination of a PD-L1 checkpoint inhibitor and an oncolytic virus in patients with advanced colorectal cancer. This study aims to evaluate the safety and efficacy of this novel therapeutic approach. Additionally, a Phase I clinical trial is assessing the safety and immunogenicity of the PolyPEPI1018 CRC Vaccine as an adjunct to standard maintenance therapy in patients with metastatic colorectal cancer. This study explores the potential of personalized vaccine strategies in enhancing anti-tumor immune responses.
These studies underscore the dynamic and evolving nature of immunotherapy research in rectal cancer, highlighting the potential for improved patient outcomes through innovative treatment strategies.
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Written by Toma Oganezova, MD
FAQ
What is immunotherapy for rectal cancer?
Immunotherapy uses the immune system to recognize and attack rectal cancer cells, especially in MSI-H or dMMR tumors.
Who is eligible for immunotherapy in rectal cancer?
Patients with MSI-H or dMMR tumors are ideal candidates. MSS patients may be considered for clinical trials.
Which drugs are used in rectal cancer immunotherapy?
Common drugs include pembrolizumab, nivolumab, ipilimumab, and dostarlimab.
How is immunotherapy given to rectal cancer patients?
It’s usually given via intravenous (IV) infusion every 2–3 weeks at a hospital or clinic.
What are the side effects of immunotherapy?
Common side effects include rash, fatigue, and diarrhea. Severe effects may include autoimmune reactions.
How long does it take to see results from immunotherapy?
Results can take weeks to months. Response time varies by patient and cancer type.
Can immunotherapy replace surgery or chemotherapy?
In some cases, like dMMR tumors, it may eliminate the need for surgery or chemo if complete response is achieved.
What is dual checkpoint immunotherapy?
It combines PD-1 inhibitors (like nivolumab) with CTLA-4 inhibitors (like ipilimumab) for enhanced immune activation.
Are there ongoing trials for rectal cancer immunotherapy?
Yes, trials are exploring combinations with chemo/radiation, vaccines, and next-gen checkpoint inhibitors.
Is immunotherapy expensive for rectal cancer?
Yes, costs can range from $10,000 to over $100,000 per year, but financial assistance programs are available.
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