Luo Zhenkai, Wang Danjun, Wang Zhexue, Zhao Hang, Xiang Renshen
Department of Endoscopy, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, China.
Department of Anesthesiology, Shanghai Geriatric Medical Center, Shanghai, China.
Front Immunol. 2025 Aug 12;16:1645412. doi: 10.3389/fimmu.2025.1645412. eCollection 2025.
Neoadjuvant immunotherapy has demonstrated satisfactory efficacy for high microsatellite instability/mismatch repair deficiency (dMMR/MSI-H) in locally advanced colorectal cancer (LACRC). This study aims to evaluate the safety and short-term efficacy of neoadjuvant immunotherapy for patients with LACRC.
We retrospectively analyzed patients with dMMR/MSI-H LACRC who received neoadjuvant immunotherapy at two Chinese medical centers. The primary outcome of the study was the pathological complete response (pCR) rate, while secondary endpoints included survival status, perioperative outcomes and safety profile.
A total of 26 patients were included in the analysis, with a median age of 58 years (range: 33-78 years). All patients underwent radical surgery after completing neoadjuvant immunotherapy. All patients achieved R0 resection, and the pCR rate was 92.3% (24/26). Furthermore, all patients experienced downstaging (100%). Eight patients (30.8%) experienced immune-related adverse events (IRAEs), and five patients (19.2%) developed postoperative complications. The median follow-up duration was 19.0 months (range: 4.0-41.0 months). No patients died during the follow-up period, and no local recurrence or distant metastasis was observed.
Neoadjuvant immunotherapy appears to be a safe and effective treatment for patients with dMMR/MSI-H LACRC, offering a feasible and acceptable therapeutic regimen before surgery.
新辅助免疫疗法已在局部晚期结直肠癌（LACRC）的高微卫星不稳定性/错配修复缺陷（dMMR/MSI-H）患者中显示出令人满意的疗效。本研究旨在评估新辅助免疫疗法对LACRC患者的安全性和短期疗效。
我们回顾性分析了在中国两家医疗中心接受新辅助免疫疗法的dMMR/MSI-H LACRC患者。该研究的主要结局是病理完全缓解（pCR）率，次要终点包括生存状况、围手术期结局和安全性。
共有26例患者纳入分析，中位年龄58岁（范围：33 - 78岁）。所有患者在完成新辅助免疫疗法后均接受了根治性手术。所有患者均实现R0切除，pCR率为92.3%（24/26）。此外，所有患者均实现降期（100%）。8例患者（30.8%）发生免疫相关不良事件（IRAEs），5例患者（19.2%）出现术后并发症。中位随访时间为19.0个月（范围：4.0 - 41.0个月）。随访期间无患者死亡，未观察到局部复发或远处转移。
新辅助免疫疗法似乎是治疗dMMR/MSI-H LACRC患者的一种安全有效的方法，为手术前提供了一种可行且可接受的治疗方案。
