Treatments after Immune Checkpoint Inhibitors in Patients with dMMR/MSI Metastatic Colorectal Cancer

Cancers

Julien Taieb¹  David Tougeron²  Romain Cohen³  Thierry André³  Thomas Pudlarz³  Quang Loc Bui³  Raphaël Colle³  Léo Mas³  Emily Alouani⁴  Rosine Guimbaud⁴  Antoine Hollebecque⁵  Christelle de la Fouchardière⁶ 

[1] Department of Digestive Oncology, Georges Pompidou European Hospital, Paris Descartes University, Sorbonne Paris Cité, 75004 Paris, France;Department of Gastroenterology, Poitiers University Hospital, 86000 Poitiers, France;Department of Medical Oncology, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Saint-Antoine, Sorbonne Université, 75012 Paris, France;Digestive Medical Oncology Department, CHU Toulouse—IUCT Rangueil-Larrey, 31059 Toulouse, France;Drug Development Department (DITEP), Gustave Roussy, Saclay University of Paris, 94800 Villejuif, France;Medical Oncology Department, Centre Leon Berard, Lyon I University, 69008 Lyon, France;

关键词: metastatic colorectal cancer;    microsatellite instability;    mismatch repair deficiency;    chemotherapy after immunotherapy;   

DOI  :  10.3390/cancers14020406

来源: DOAJ

【 摘 要 】

Background: Several studies reported improved outcomes with conventional treatments (CT, i.e., chemotherapy ± targeted therapy) administered after immune checkpoints inhibitors (ICI) in certain tumor types. No data are available concerning patients (pts) with metastatic colorectal cancer (mCRC) harboring mismatch repair deficiency/microsatellite instability (dMMR/MSI). We aimed to assess the outcomes of dMMR/MSI mCRC pts receiving CT after ICI failure. Methods: We conducted a retrospective multicenter study investigating the outcomes of all dMMR/MSI mCRC pts who received post-ICI CT between 2015 and 2020. Results: 31 pts (male 61%, median age 56 years) were included. ICI was an anti-PD(L)1 monotherapy in 71% of pts, and 61% received >2 lines before post-ICI CT. The overall response rate and disease control rate were 13% and 45%, with a median progression-free survival (PFS) and overall survival of 2.9 and 7.4 months, respectively. No association of the outcomes with either ICI efficacy or anti-angiogenic agents was observed. Prolonged PFS (range 16.1–21.3 months) was observed in 4 pts (13%). Conclusions: Although conducted on a limited number of patients, our results do not support an association of previous ICI treatment with an enhanced efficacy of CT in dMMR/MSI mCRC. However, prolonged disease control was observed in several cases, suggesting that some pts might derive an unexpected benefit from post-ICI treatments.

【 授权许可】

Unknown