Gertjan Rasschaert, Medical Doctor and Consultant specializing in Gastrointestinal Oncology and Gastroenterology at UZ Leuven, shared a post on LinkedIn:
“‘Immunotherapy—could that be an option for me, doctor?’ is the ever returning question from our colorectal cancer patients. The straightforward answer has long been: ‘No, it does not work.’ However, mounting evidence from both fundamental and clinical research suggests that this answer is no longer appropriate.
The Lancet invited me to comment on STELLAR-303 in parallel to its publication. It is the first trial of its kind in chemorefractory, mismatch repair proficient, metastatic colorectal cancer with immunotherapy, here combined with a tyrosine kinase inhibitor, zanzalintinib, that is positive for overall survival (OS). This can be perceived as ‘historic’, albeit some nuance and perspective are expedient. No better partner in crime to team up with than sabine Tejpar.
Key takeaways from our side:
- Absolute OS gain is low (1.5 months)
- Hazard ratio is high (0.8)
- Overall response rate is low at 4%, especially when comparing to other up-and-coming immunotherapy based regimens in this setting.
- While there are no new safety concerns reported, our interpretation of the reporting is that this combo is rather toxic. Especially in a third line setting. Especially when benchmarking to regorafenib.
- Most intriguing are the equal colorectal liver metastases (CLM) responses. Now that is new in this setting..
- Particularly this CLM point warrants further retrospective biomarker discovery.
- Since all-comers trials with only marginal gains risk on killing health care systems they also pose a threat to our patients.
- The race is open: a wave of Fc-modified anti-CTLA-4, bispecific antibodies, T cell engagers and others are coming (in early lines!)”
Title: The dawn of immunotherapy in mismatch repair proficient colorectal cancer
Authors: Gertjan Rasschaert, Sabine Tejpar
Read the Full Article on The Lancet
More posts featuring Gertjan Rasschaert.