What is the role of immunotherapy in the treatment of colon cancer?

Updated: Apr 15, 2020
  • Author: Tomislav Dragovich, MD, PhD; Chief Editor: N Joseph Espat, MD, MS, FACS  more...
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Answer

For patients with dMMR/MSI-H tumors who are not eligible for cytotoxic combinations, National Comprehensive Cancer Network (NCCN) guidelines recommend the following as first-line immunotherapy options [93] :

  • Nivolumab
  • Pembrolizumab
  • Nivolumab plus ipilimumab

The NCCN recommends nivolumab with or without ipilimumab or pembrolizumab for the second- and third-line treatment of patients with dMMR/MSI-H colorectal cancer.

Besides determining the status of MMR and/or MSI, the NCCN Panel has expanded its recommendation for biomarker testing to include KRAS/RAS or BRAF mutations, HER2 amplifications, and NTRK fusions in patients with mCRC. The determination of these tumor markers provides more treatment options for mCRC patients. [93]


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