Rishabh Jain, Medical Oncologist at AIIMS, shared a post on X:
“Real-world data confirms what clinical trials have been telling us.
Neoadjuvant immunotherapy produces remarkable responses in localized dMMR/MSI colorectal cancer, while generating 2 important hypotheses on treatment strategy.
ESMOGI26 | AGEO-NEO-MSI (n=316)
Largest international real-world cohort of neoadjuvant ICIs in non-metastatic dMMR/MSI CRC.
Key efficacy
- Complete response (pCR + cCR): 67%
- Clinical CR: 34%
Among resected patients:
- MPR: 75%
- pCR: 64%
Durable outcomes
- 12-month EFS: 92%
- 24-month EFS: 86%
Two intriguing signals
Short-course dual ICI (<1 month) achieved higher complete response than prolonged single-agent ICI
- Adjusted OR 2.46 (95% CI 1.21 to 5.38)
Dual ICI also increased severe immune toxicity
- Grade ≥3 irAEs: 12.5% vs 4.5%
Take-home
This study strengthens the case for neoadjuvant immunotherapy in localized dMMR/MSI CRC. It also raises an important question:
Could a shorter, more intensive dual ICI strategy maximize cure while minimizing treatment duration?
Prospective validation is still needed before changing practice.
Would this influence your neoadjuvant approach?”
Other articles about GI Oncology on OncoDaily.