Paradigm shift from palliation to cure in metastatic microsatellite high colorectal carcinoma with immune checkpoint inhibitors
Paradigm shift from palliation to cure in metastatic microsatellite high colorectal carcinoma with immune checkpoint inhibitors
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DOI：
10.4103/jcrt.jcrt_156_21
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发表时间：
2021-10-01
影响因子：
1.3
通讯作者：
Shaikh, Imran Nisar
中科院分区：
文献类型：
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作者：
Dhamani, Anjum Mehmood;Sheth, Hardik Sanjeev;Shaikh, Imran Nisar
结直肠癌（Colorectal carcinoma，CRC）是世界范围内最常见的恶性肿瘤之一，死亡率高。CRC通常受到显著的治疗相关发病率和死亡率的困扰，并且转移进展是常见的。随着免疫疗法的出现，不能手术的晚期癌症已经显示出良好的反应。免疫疗法为所有晚期转移性疾病患者的生存铺平了道路，这些患者的治疗仅限于姑息治疗。我们探讨了一例28岁女性晚期转移性CRC患者，化疗和靶向治疗难治，PD-1抑制剂治疗后在相对较短的时间内获得了完全的临床和病理学缓解。在我们的病例中观察到的良好反应肯定加强了对具有微卫星不稳定性的晚期转移性CRC进行前期免疫治疗的概念，我们希望这些发现有助于减少对化疗的依赖，化疗是晚期CRC的主要治疗方法。
Colorectal carcinoma (CRC) is one of the most frequently diagnosed malignancies worldwide with a high mortality rate. CRC is often plagued with significant treatment-related morbidity and mortality, and metastatic progression is common. With the advent of immunotherapy, inoperable and advanced cancers have shown favorable response. Immunotherapy has paved the way for survival of all those with advanced metastatic disease whose treatment was limited to palliative care. We explore the case of a 28-year-old female with advanced metastatic CRC refractory to chemotherapy and targeted therapy, managed with PD-1 inhibitor with complete clinical and pathological response in a relatively short period of time. The notion of upfront immunotherapy for advanced metastatic CRC with microsatellite instability is definitely reinforced by the favorable response seen in our case, and we hope that these findings would help reduce the dependence on chemotherapy as the mainstay therapeutic for advanced CRC.