Dr. Overman on Unmet Needs With Immunotherapy in mCRC

Michael J. Overman, MD, associate professor, Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, discusses unmet needs with immunotherapy in metastatic colorectal cancer (mCRC).

The biggest challenge with extending the reach of immunotherapy in this space is that despite the high level of activity, there is still a subset of patients who don’t respond to this approach. Because these patients have immunologic factors such as high mutation burden and many neoantigens, one would think that all microsatellite instability-high patients would benefit from immunotherapy. However, that is not the case.

There are clearly mechanisms of resistance at play that researchers have not yet discovered, says Overman. Moving forward, a big question will be whether these mechanisms can be identified and then exploited with targeted therapy or other strategies. There is a lot of hope that this can be accomplished with time, but right now it’s a lot of translational analysis. To date, the question remains unanswered.