Immunotherapy May Be Effective for Subgroup of Metastatic Colorectal Cancer Patients, City of Hope Study Finds


DUARTE, Calif .– (COMMERCIAL THREAD) – Researchers at City of Hope, a world-renowned research and treatment center for cancer, diabetes and other life-threatening diseases, looked at the most common type of metastatic colorectal cancer and found that these patients are more sensitive to immunotherapy by blocking checkpoints. , an innovative treatment that helps the immune system recognize and attack cancer cells, if the tumors have not spread to the liver.

Colorectal cancer is the third most common cancer and the leading cause of cancer-related death in the United States, according to the Centers for Disease Control and Prevention. The City of Hope findings, published today in JAMA Network Open, are important because immunotherapy has traditionally been considered ineffective against stable microsatellite colorectal cancer (MSS), which accounts for 95% of all metastatic colorectal cancer cases. . These patients have few treatment options once they become resistant to chemotherapy.

The retrospective study included 95 City of Hope patients with MSS metastatic colorectal cancer who received targeted therapy with a PD-1 / PD-L1 immune checkpoint inhibitor after their disease became resistant to the chemotherapy. The median time to disease progression for patients who did not have liver metastases was four months versus one and a half months for those whose cancer had spread to the liver.

“When we stratified the patients according to the presence or absence of liver metastases, we noted that approximately 20% of patients without liver metastases had a major response to anti-PD-1 or anti-PD-L1 therapy, so that none of the patients with liver metastases experienced a positive response, ”said Marwan Fakih, MD, co-director of the gastrointestinal cancer program and Judy & Bernard Briskin, distinguished director of clinical research at City of Hope. “Patients with colorectal cancer without liver metastases could benefit from immunotherapy considerably more than patients with liver metastases.”

When colorectal cancer spreads to the liver, some patients may have surgery to remove all the tumors; however, sometimes these tumors cannot be removed surgically. This is when chemotherapy is used, but “chemotherapy is meant to stop working and we have to look for additional treatment options,” Fakih said, adding, “To our knowledge, this is of the largest study to assess the impact of PD-1 / PD-L1 Targeting on patient response stratified by site of metastatic disease.

The clinical significance, said Fakih, is that patients with advanced colorectal cancer with liver metastases should not be considered for treatment with PD-1 / PD-L1. Instead, other new investigative strategies are recommended.

“For patients without metastatic liver disease, PD-1 / PD-L1-based therapies, especially those combining these agents with tyrosine kinase (TKI) inhibitors, show great promise,” he said. stated, noting that TKIs that target the tumor vasculature alter the tumor environment and make it more responsive to PD-1 / PD-L1 therapy.

About City of Hope

City of Hope is an independent center for biomedical research and treatment of cancer, diabetes and other life-threatening diseases. Founded in 1913, City of Hope is a leader in bone marrow transplantation and immunotherapy such as CAR T cell therapy. City of Hope translational research and personalized treatment protocols advance care in the whole world. Human synthetic insulin, monoclonal antibodies and many revolutionary cancer drugs are based on technology developed at the institution. A comprehensive cancer center designated by the National Cancer Institute and a founding member of the National Comprehensive Cancer Network, City of Hope is ranked among the “Best Hospitals” in the country for cancer by US News & World Report. Its main campus is located near Los Angeles, with additional locations in Southern California and Arizona. The Translational Genomics Research Institute (TGen) became part of City of Hope in 2016. AccessHope ™, an affiliate launched in 2019, serves employers and their healthcare partners by giving them access to the expertise of cancer centers designated by the NCI. For more information on City of Hope, follow us on Facebook, Twitter, YouTube or Instagram.

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