Anti-PD-1-based immunotherapy as curative-intent treatment in dMMR/MSI-H rectal cancer: A multicentre cohort study

作者全名："Wang, Qiao-Xuan; Xiao, Bin-Yi; Cheng, Yong; Wu, Ai-Wen; Zhang, Tao; Wang, Hui; Zhang, Xuan; Huang, Wei-Xin; Tang, Jing-Hua; Jiang, Wu; Steele, Scott R.; Krishnamurthi, Smitha; Li, Yuan; Cai, Jian; Kong, Ling-Heng; Li, Dan-Dan; Pan, Zhi-Zhong; Zhang, Xiao-Shi; Ding, Pei-Rong"

作者地址："[Wang, Qiao-Xuan] Sun Yat Sen Univ, Collaborat Innovat Ctr Canc Med, Dept Radiat Oncol, State Key Lab Oncol South China,Canc Ctr, Guangzhou, Peoples R China; [Xiao, Bin-Yi; Tang, Jing-Hua; Jiang, Wu; Li, Yuan; Kong, Ling-Heng; Pan, Zhi-Zhong; Ding, Pei-Rong] Sun Yat Sen Univ, Collaborat Innovat Ctr Canc Med, Dept Colorectal Surg, State Key Lab Oncol South China,Canc Ctr, Guangzhou, Peoples R China; [Cheng, Yong] Chongqing Med Univ, Affiliated Hosp 1, Dept Gastrointestinal Surg, Chongqing, Peoples R China; [Wu, Ai-Wen] Peking Univ, Dept Gastrointestinal Surg, Minist Educ,Key Laboratory of Carcinogenesis & Tra, Gastrointestinal Canc Ctr,Canc Hosp & Inst, Beijing, Peoples R China; [Zhang, Tao] Chongqing Med Univ, Affiliated Hosp 1, Dept Oncol, Chongqing, Peoples R China; [Wang, Hui] Sun Yat sen Univ, Affiliated Hosp 6, Guangdong Inst Gastroenterol, Dept Colorectal Surg,Guangdong Prov Key Lab Colore, Guangzhou, Peoples R China; [Zhang, Xuan] Kunming Med Univ, Yunnan Canc Hosp, Affiliated Hosp 3, Dept Colorectal Surg, Kunming, Peoples R China; [Huang, Wei-Xin] Honghe Canc Hosp, Honghe Prefecture Third Peoples Hosp, Dept Gastrointestinal Surg, Gejiu, Peoples R China; [Steele, Scott R.] Cleveland Clin, Digest Dis & Surg Inst, Dept Colorectal Surg, Cleveland Hts, OH USA; [Krishnamurthi, Smitha] Cleveland Clin Cleveland, Taussig Canc Inst, Dept Hematol & Oncol, Cleveland, OH USA; [Li, Dan-Dan; Zhang, Xiao-Shi] Sun Yat Sen Univ, Dept Biol Therapy Ctr, Collaborat Innovat Ctr Canc Med, State Key Lab Oncol South China,Canc Ctr, Guangzhou, Peoples R China; [Ding, Pei-Rong] Sun Yat Sen Univ, Collaborat Innovat Ctr Canc Med, State Key Lab Oncol South China, Dept Colorectal Surg,Canc Ctr, 651,Dongfeng Rd East, Guangzhou 510060, Peoples R China"

通信作者："Ding, PR (通讯作者)，Sun Yat Sen Univ, Collaborat Innovat Ctr Canc Med, State Key Lab Oncol South China, Dept Colorectal Surg,Canc Ctr, 651,Dongfeng Rd East, Guangzhou 510060, Peoples R China."

来源：EUROPEAN JOURNAL OF CANCER

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000858608000001

JCR分区：Q1

影响因子：8.4

年份：2022

卷号：174

期号：　

开始页：176

结束页：184

文献类型：Article

关键词：Anti-PD-1 immunotherapy; Curative-intent; dMMR; MSI-H; Rectal cancer; Organ preservation

摘要："Background: In a portion of patients with DNA mismatch repair-deficient (dMMR)/microsatellite instability-high (MSI-H) rectal cancer, clinical complete response (cCR) could be achieved after anti-programmed cell death protein 1 (anti-PD-1) immuno-therapy. However, no data are available concerning the safety of omitting surgery and adopt-ing immunotherapy as a curative-intent treatment for these patients.Methods: We retrospectively collected a series of patients with dMMR/MSI-H rectal adeno-carcinoma who had cCR after receiving anti-PD-1 immunotherapy and adopted immuno-therapy as curative-intent treatment from six institutions. Survival outcomes were analysed using the Kaplan-Meier method.Results: Nineteen patients were included with a median age of 48 (range 19-63). One patient was diagnosed with stage I disease, four with stage II disease and fourteen with stage III disease. Sixteen patients received anti-PD-1 immunotherapy as the first line of therapy, and eleven patients were treated with single-agent anti-PD-1 antibodies. The median time from the start of treatment to cCR was 3.8 (range 0.7-6.5) months. During a median follow-up of 17.1 (range 3.1-33.5) months since achieving cCR, no local or distant relapse was observed. Two-year local recurrence-free survival, distant metastasis-free survival, disease free-survival and overall survival for the whole cohort were 100%, 100%, 100% and 100%, respectively.Conclusions: For patients with dMMR/MSI-H locally advanced rectal cancer who achieved cCR during anti-PD-1 immunotherapy, adopting immunotherapy as curative-intent treatment might be an alternative option. Longer follow-up and larger cohorts are warranted to verify this innovative treatment approach.(c) 2022 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)."

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