Dr. Lenz on Potential for Immunotherapy in mCRC

Heinz-Josef Lenz, MD, associate director for Adult Oncology and co-leader of the Gastrointestinal Cancers Program, USC Norris Comprehensive Cancer Center, discusses the potential for immunotherapy in the treatment of patients with metastatic colorectal cancer (mCRC).

Right now, the impact of checkpoint inhibitors is only being observed in a small subset of patients whose tumors express microsatellite instability high (MSI-H) or mismatch repair deficiency (dMMR). First results of a study evaluating the use of neoadjuvant ipilimumab (Yervoy) plus nivolumab (Opdivo) in patients with early-stage colon cancer, showed a major pathologic response in all 7 patients who had mismatch repair deficient tumors. Major pathologic responses were not observed in the 8 patients with MMR proficient tumors, according to the data presented at the 2018 ESMO Congress.

Lenz says that based on these encouraging data, this immunotherapy combination has potential to move to the frontline setting for this patient population. For microsatellite stable tumors, immunotherapy agents might make some headway when used in combination with chemotherapy. He adds that there are ongoing trials looking at FOLFOXIRI and bevacizumab (Avastin) in combination with nivolumab.