Case report: A combined immunotherapy strategy as a promising therapy for MSI-H colorectal carcinomas with multiple HPD risk factors

Frontiers in Medicine

Medicine

Di Wu¹  Lei Liu¹  Baoru Hu¹  Jinli Zhang¹  Fanwei Kong²  Jiaxin He³  Lu Yang³  Jie Yang³ 

[1] Department of Internal Medicine, Harbin Medical University Cancer Hospital, Harbin, China;Department of Physical Diagnosis, Heilongjiang Province Hospital, Harbin, China;The Genetic Analysis Department, YuceBio Technology Co., Ltd., Shenzhen, China;

关键词: colorectal carcinoma;    MSI-H;    immunotherapy;    chemotherapy;    HPD;   

DOI  :  10.3389/fmed.2023.1051034

 received in 2022-09-22, accepted in 2023-04-03,  发布年份 2023

来源: Frontiers

【 摘 要 】

Approximately 5% of advanced colorectal carcinomas (CRCs) and 12–15% of early CRCs are microsatellite instability-high (MSI-H) or mismatch repair-deficient (dMMR) tumors. Nowadays, PD-L1 inhibitors or combined CTLA4 inhibitors are the major strategies for advanced or metastatic MSI-H colorectal cancer, but some people still show drug resistance or progression. Combined immunotherapy has been shown to expand the benefit population in non-small-cell lung carcinoma (NSCLC), hepatocellular carcinoma (HCC), and other tumors while reducing the incidence of hyper-progression disease (HPD). Nevertheless, advanced CRC with MSI-H remains rare. In this article, we describe a case of an elder patient with MSI-H advanced CRC carrying MDM4 amplification and DNMT3A co-mutation who responded to sintilimab plus bevacizumab and chemotherapy as the first-line treatment without obvious immune-related toxicity. Our case provides a new treatment option for MSI-H CRC with multiple risk factors of HPD and highlights the importance of predictive biomarkers in personalized immunotherapy.

【 授权许可】

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Copyright © 2023 Zhang, Yang, Kong, Wu, Hu, Yang, He and Liu.