ORIGINAL RESEARCH article
Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1645412
This article is part of the Research TopicColorectal Cancer Immunotherapy and Immune MechanismsView all 11 articles
Is neoadjuvant immunotherapy feasible for patients with dMMR/MSI-H locally advanced colorectal cancer? A retrospective study
Provisionally accepted
- 1Zhejiang Cancer Hospital, Hangzhou, China
- 2Shanghai Geriatric Medical Center, Shanghai, China
- 3Peking Union Medical College Graduate School, Beijing, China
- 4Fudan University Shanghai Cancer Center, Shanghai, China
- 5Tianjin Medical University Cancer Institute & Hospital National Clinical Research Center for Cancer, Tianjin, China
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Background: 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. Methods: 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. Results: 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. Conclusion: 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.
Keywords: locally advanced colorectal cancer (LACRC), Immunotherapy, Neoadjuvant Therapy, microsatellite instability (MSI), Pathological complete response
Received: 11 Jun 2025; Accepted: 23 Jul 2025.
Copyright: © 2025 Luo, Wang, Wang, Zhao and Xiang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Zhenkai Luo, Zhejiang Cancer Hospital, Hangzhou, China
Renshen Xiang, Tianjin Medical University Cancer Institute & Hospital National Clinical Research Center for Cancer, Tianjin, China
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