A pathological complete response after nivolumab plus ipilimumab therapy for DNA mismatch repair‑deficient/microsatellite instability‑high metastatic colon cancer: A case report

Igaue, Shota; Okuno, Takayuki; Ishibashi, Hajime; Nemoto, Masaru; Hiyoshi, Masaya; Kawasaki, Hiroshi; Saitoh, H; Saitoh, Makoto; Akagi, Kiwamu; Yamamoto, Junji

doi:10.3892/ol.2022.13332

Cited by 5 publications

(2 citation statements)

References 31 publications

(34 reference statements)

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“…For T4b disease, nivolumab (Opdivo) with or without ipilimumab (Yervoy) or pembrolizumab can be used as an alternative to chemotherapy in the neoadjuvant setting for dMMR or MSI-H tumors. Interestingly, this recommendation has appeared in the medical literature and guidelines ( Ludford et al, 2023 ; Igaue et al, 2022 ) but not in the FDA-approved prescribing information for these drugs ( Merck, 2014 ; Bristol Myers Squibb, 2014 ; Bristol Myers Squibb, 2011 ). However, for unresectable or metastatic colorectal cancer with dMMR or MSI-H, both pembrolizumab as well as nivolumab (with or without ipilimumab) fall within the approved labels for each drug.…”

Section: Biomarkers In Solid Tumorsmentioning

confidence: 99%

The Role of Biomarkers in Guiding Clinical Decision-Making in Oncology

C. Moore, PharmD, BCPS, BCOP, DPLA, FCCP,

S. Guinigundo, MSN, RN, CNP, ANP-BC

2023

JADPRO

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Recent advances in molecular diagnostics have led to the characterization of an increasing number of actionable genomic alterations and immune-based signatures, which have facilitated the development of many highly effective cancer therapies. In addition to their prognostic value, some of these biomarkers have been shown to have predictive value and have had a significant impact on clinical decision-making. The presence of these therapeutic targets can thus aid health-care professionals to select the optimal therapies and avoid use of ineffective, potentially toxic ones. Earlier agents were generally approved for only one or a limited number of malignancies and/or stages, but more recent approvals encompass multiple tumor types that bear a common molecular alteration regardless of tumor type (i.e., tumor-agnostic indications). The expanding use of tumor-agnostic biomarkers has the potential to greatly broaden the use of these therapies to a wider patient population. Yet the rapidly increasing number of tumor-specific and tumor-agnostic biomarkers, and the continually changing treatment guidelines regarding the use of targeted agents and associated testing requirements, present challenges for advanced practitioners to remain current on these topics and their ability to apply these advances to clinical care. Here, we review predictive oncology biomarkers currently in use and their role in clinical decision-making, including those specified in product prescribing information and clinical practice guidelines. Current clinical guidelines regarding recommended targeted therapies for selected malignancies, and when molecular testing should be performed, are discussed.

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Section: Biomarkers In Solid Tumorsmentioning

confidence: 99%

The Role of Biomarkers in Guiding Clinical Decision-Making in Oncology

C. Moore, PharmD, BCPS, BCOP, DPLA, FCCP,

S. Guinigundo, MSN, RN, CNP, ANP-BC

2023

JADPRO

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“…Inhibition of CTLA-4 may lead to reactivation of T cells allowing them to overcome tumor-induced immune tolerance ( 25 ). Ipilimumab (Yervoy) is an anti-CTLA-4 antibody used in metastatic dMMR/MSI-H patients in combination with nivolumab ( 26 ). This combination of nivolumab and low-dose ipilimumab produced an objective response rate of 64%, complete response rate of 9%, and disease control rate of 84%, all of which were durable ( 27 ).…”

Section: Microsatellite Instabilitymentioning

confidence: 99%

Biomarkers in the development of individualized treatment regimens for colorectal cancer

Crutcher

2022

Front. Med.

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IntroductionColorectal cancer (CRC) is the third most common and second most deadly malignancy in the world with an estimated 1. 9 million cases and 0.9 million deaths in 2020. The 5-year overall survival for stage I disease is 92% compared to a dismal 11% in stage IV disease. At initial presentation, up to 35% of patients have metastatic colorectal cancer (mCRC), and 20–50% of stage II and III patients eventually progress to mCRC. These statistics imply both that there is a proportion of early stage patients who are not receiving adequate treatment and that we are not adequately treating mCRC patients.BodyTargeted therapies directed at CRC biomarkers are now commonly used in select mCRC patients. In addition to acting as direct targets, these biomarkers also could help stratify which patients receive adjuvant therapies and what types. This review discusses the role of RAS, microsatellite instability, HER2, consensus molecular subtypes and ctDNA/CTC in targeted therapy and adjuvant chemotherapy.DiscussionGiven the relatively high recurrence rate in early stage CRC patients as well as the continued poor survival in mCRC patients, additional work needs to be done beyond surgical management to limit recurrence and improve survival. Biomarkers offer both a potential target and a predictive method of stratifying patients to determine those who could benefit from adjuvant treatment.

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