Jemperli (Dostarlimab-gxly): An unprecedented cancer trial

Ali, Eman; Ellahi, Aayat; Adil, Mariam; Shaikh, Asim; Huda, Zunera

doi:10.1016/j.amsu.2022.104047

Cited by 1 publication

(1 citation statement)

References 6 publications

(6 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The feasibility of neoadjuvant therapy in operable, localized colon cancer was shown in the FOxTROT trial . Subsequently, neoadjuvant ICI treatment was evaluated in localized dMMR CRCs (Table 1 and Table 2) given the dramatic response to ICIs observed in metastatic disease. NICHE-1 was the first prospective trial to evaluate the role of neoadjuvant ICIs in patients with colon cancer, and in its exploratory phase, patients with dMMR and pMMR were enrolled, including 32 of 62 with resectable stage I to III dMMR tumors.…”

Section: Introductionmentioning

confidence: 99%

Neoadjuvant Immune Checkpoint Inhibitor Therapy for Localized Deficient Mismatch Repair Colorectal Cancer

Emiloju,

Sinicrope

2023

JAMA Oncol

View full text Add to dashboard Cite

ImportanceColorectal cancers (CRCs) with deficient DNA mismatch repair (dMMR) account for 15% of all CRCs. Deficient MMR is a predictive biomarker associated with responsiveness to immune checkpoint inhibitors (ICIs) in solid tumors, including CRC. The remarkable effectiveness of ICIs in metastatic CRC has led to their evaluation in the neoadjuvant and adjuvant treatment of localized disease.ObservationsMultiple prospective phase 2 studies in limited numbers of patients with localized dMMR CRC demonstrate high complete clinical and pathological response rates (60%-100%) to neoadjuvant ICIs, with low rates of grade 3 or higher ICI-related toxic effects. Given the median follow-up of 12 to 25 months in these studies, longer-term monitoring is needed to determine the durability of response and to ensure that oncologic outcomes are not compromised in patients undergoing nonoperative management. Neoadjuvant ICI therapy is especially attractive for patients with rectal cancer given the significant morbidity that accompanies pelvic irradiation and total mesorectal excision. Ongoing and planned prospective phase 2 trials will provide further data on important issues, including optimal neoadjuvant treatment duration, ICI monotherapy vs combination, and the need for adjuvant ICI therapy.Conclusions and RelevanceWhile this review found that early results of neoadjuvant immunotherapy for localized dMMR CRC show high rates of major and complete pathological response, longer-term follow-up data are needed to ensure that oncologic outcomes are not compromised and are ideally improved. Neoadjuvant ICI therapy in localized dMMR CRC represents a potential paradigm shift with implications for organ preservation.

show abstract

Section: Introductionmentioning

confidence: 99%