Dr. Benson on the Ongoing Research With Immunotherapy in mCRC

Al B. Benson, MD, professor of medicine, Hematology and Oncology, Northwestern University Feinberg School of Medicine, discusses ongoing research with immunotherapy in metastatic colorectal cancer (mCRC).

Currently, research with immunotherapy is limited to patients with microsatellite instability—high (MSI–H) tumors, says Benson. Studies have shown the activity of pembrolizumab (Keytruda) and nivolumab (Opdivo), as well as the combination of nivolumab and ipilimumab (Yervoy). Whether checkpoint inhibitors should be used alone or in combination is an area of active investigation, explains Benson. A patient with MSI-H mCRC has a worse prognosis. If the patient progressed on frontline therapy, a combination therapy could induce a quicker response compared with single-agent therapy.

Investigators are also evaluating immunotherapy in the adjuvant setting, says Benson. The challenge is making the approach effective for the majority of patients who are not MSI-H. Potential strategies to overcome the limitations of single-agent immunotherapy in patients with microsatellite stable disease population include combinations of immunotherapy with radiation, liver-directed therapy, chemotherapy, targeted agents, and vaccines, says Benson.