Vora Kruti B, Tolay Sameer, Parikh Aparna R, Chakrabarti Sakti
Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
Oncology, SSM Health St. Agnes Hospital, Fond du Lac, USA.
Cureus. 2022 May 26;14(5):e25351. doi: 10.7759/cureus.25351. eCollection 2022 May.
The organ preservation strategy in non-metastatic rectal cancer is a rapidly evolving, novel treatment paradigm that is offered outside of a clinical trial in many advanced cancer centers. However, for non-metastatic colon cancer, upfront surgery followed by adjuvant chemotherapy in patients deemed at risk of cancer recurrence is the current standard of care. A significant proportion of patients with non-metastatic colon cancer harbor a deficient mismatch repair (dMMR)/microsatellite instability-high (MSI-H) signature in tumors, which predicts a deep and durable response to immune checkpoint inhibitors (ICI) in a large proportion of such patients. This opens an opportunity for organ preservation in colon cancer in select circumstances. Herein, we describe a patient with locally advanced dMMR/MSI-H colon cancer who could not undergo standard colon surgery but achieved complete remission following treatment with ICI.
非转移性直肠癌的器官保留策略是一种迅速发展的新型治疗模式，在许多先进癌症中心的临床试验之外也有应用。然而，对于非转移性结肠癌，对于被认为有癌症复发风险的患者，先行手术然后进行辅助化疗是当前的标准治疗方案。相当一部分非转移性结肠癌患者的肿瘤存在错配修复缺陷（dMMR）/微卫星高度不稳定（MSI-H）特征，这预示着这些患者中的很大一部分对免疫检查点抑制剂（ICI）有深度且持久的反应。这为在特定情况下保留结肠癌患者的器官提供了机会。在此，我们描述了一名局部晚期dMMR/MSI-H结肠癌患者，该患者无法接受标准的结肠手术，但在接受ICI治疗后实现了完全缓解。
