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Review
. 2023 Apr 9;36(6):378-384.
doi: 10.1055/s-0043-1767703. eCollection 2023 Nov.

Nonoperative Management of dMMR/MSI-H Colorectal Cancer following Neoadjuvant Immunotherapy: A Narrative Review

Binyi Xiao  1 , Jiehai Yu  1 , Pei-Rong Ding  1
Affiliations
Review

Nonoperative Management of dMMR/MSI-H Colorectal Cancer following Neoadjuvant Immunotherapy: A Narrative Review

Binyi Xiao et al. Clin Colon Rectal Surg. .

Abstract

Immunotherapy with PD-1 blockade has achieved a great success in colorectal cancers (CRCs) with high microsatellite instability (MSI-H) and deficient mismatch repair (dMMR), and has become the first-line therapy in metastatic setting. Studies of neoadjuvant immunotherapy also report exciting results, showing high rates of clinical complete response (cCR) and pathological complete response. The high efficacy and long duration of response of immunotherapy has prompt attempts to adopt watch-and-wait strategy for patients achieving cCR following the treatment. Thankfully, the watch-and-wait approach has been proposed for nearly 20 years for patients undergoing chemoradiotherapy and has gained ground among patients as well as clinicians. In this narrative review, we combed through the available information on immunotherapy for CRC and on the watch-and-wait strategy in chemoradiotherapy, and looked forward to a future where neoadjuvant immunotherapy as a curative therapy would play a big part in the treatment of MSI-H/dMMR CRC.

Keywords: Colorectal Cancer; PD-1 inhibitor; deficient mismatch repair; high microsatellite instability; immunotherapy.

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Conflict of interest statement

Conflict of Interest P.-R.D. declared receiving Honoraria from: Roche, MSD, Sanofi, Medtronic, and Johnson & Johnson. There is no conflict of interest among the authors in this study.

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