Dr. Jiang on the Future of Immunotherapy in Microsatellite Stable Colorectal Cancer

Yixing Jiang, BM, PhD, associate professor of medicine, director, Gastrointestinal Medical Oncology Marlene Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, discusses the future of immunotherapy in microsatellite stable (MSS) colorectal cancer (CRC).

Although the combination of durvalumab (Imfinzi) and tremelimumab induced modest responses in patients with MSS CRC, it is difficult to say whether immunotherapy has a future in this subset of patients. One of the challenges with immunotherapy is that physicians do not have a validated biomarker with which to measure response to the approach, says Jiang. Current investigational combinations with immunotherapy are based on theoretical mechanisms, adds Jiang. It may be that immunotherapy may never find its way into practice for patients with MSS tumors.

In terms of investigational strategies, anti—PD-1 and anti–VEGF therapy with bevacizumab (Avastin) are being explored. Although this combination was evaluated in patients with hepatocellular carcinoma and was shown to be very effective, results from the phase I/II MEDI4736 trial suggested that the combination may not carry the same benefit in CRC, says Jiang.