Immune checkpoint inhibitors for patients with isolated peritoneal carcinomatosis from dMMR/MSI-H colorectal cancer, a BIG-RENAPE collaboration.

Humans Immune Checkpoint Inhibitors / therapeutic use Peritoneal Neoplasms / drug therapy Cohort Studies Colonic Neoplasms / drug therapy Colorectal Neoplasms / pathology Microsatellite Instability DNA Mismatch Repair
Colorectal cancer Cytoreductive surgery Immunotherapy Microsatellite instability Peritoneal carcinomatosis

Journal

Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
ISSN: 1878-3562
Titre abrégé: Dig Liver Dis
Pays: Netherlands
ID NLM: 100958385

Informations de publication

Date de publication:
05 2023
Historique:
received: 05 08 2022
revised: 21 09 2022
accepted: 23 09 2022
medline: 1 5 2023
pubmed: 21 10 2022
entrez: 20 10 2022
Statut: ppublish

Résumé

Immunotherapy with immune checkpoint inhibitors has significantly improved the survival of patients with MSI/dMMR mCRC. These tumors are associated with a specific metastatic spread, i.e. frequent peritoneal carcinomatosis (PC) that may be treated surgically when there is no other metastatic location. We aimed at evaluating the prognosis of patients treated with immune checkpoint inhibitors for MSI/dMMR mCRC with isolated PC. All consecutive patients with isolated PC from MSI/dMMR mCRC, initially considered as unresectable by multidisciplinary team meeting, treated with immune checkpoint inhibitors were included in this French multicenter cohort study. Among 45 patients included, we observed 11 complete responses and 10 partial responses for an overall response rate iRECIST of 46%. After a median follow-up of 24.4 months, the median progression-free survival (PFS) and overall survival (OS) were not reached. Seven of the eight patients who underwent cytoreductive surgery after treatment with anti-PD1 ± anti-CTLA-4 were in complete pathologic response. These results demonstrate long-term benefit of immune checkpoint inhibitors for patients with isolated PC from MSI/dMMR mCRC. Such treatment appears as the best therapeutic option for patients with isolated PC from MSI/dMMR mCRC. With a majority of pathological complete responses for patients who underwent surgery for residual lesions, the value of such therapeutic strategy remains unknown.

Sections du résumé

BACKGROUND
Immunotherapy with immune checkpoint inhibitors has significantly improved the survival of patients with MSI/dMMR mCRC. These tumors are associated with a specific metastatic spread, i.e. frequent peritoneal carcinomatosis (PC) that may be treated surgically when there is no other metastatic location. We aimed at evaluating the prognosis of patients treated with immune checkpoint inhibitors for MSI/dMMR mCRC with isolated PC.
MATERIAL AND METHODS
All consecutive patients with isolated PC from MSI/dMMR mCRC, initially considered as unresectable by multidisciplinary team meeting, treated with immune checkpoint inhibitors were included in this French multicenter cohort study.
RESULTS
Among 45 patients included, we observed 11 complete responses and 10 partial responses for an overall response rate iRECIST of 46%. After a median follow-up of 24.4 months, the median progression-free survival (PFS) and overall survival (OS) were not reached. Seven of the eight patients who underwent cytoreductive surgery after treatment with anti-PD1 ± anti-CTLA-4 were in complete pathologic response.
CONCLUSION
These results demonstrate long-term benefit of immune checkpoint inhibitors for patients with isolated PC from MSI/dMMR mCRC. Such treatment appears as the best therapeutic option for patients with isolated PC from MSI/dMMR mCRC. With a majority of pathological complete responses for patients who underwent surgery for residual lesions, the value of such therapeutic strategy remains unknown.

Identifiants

DOI: 10.1016/j.dld.2022.09.015 PMID: 36266207
pubmed: 36266207
pii: S1590-8658(22)00726-5
doi: 10.1016/j.dld.2022.09.015
pii:
doi:

Substances chimiques

Immune Checkpoint Inhibitors 0

Types de publication

Multicenter Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

673-678

Informations de copyright

Copyright © 2022. Published by Elsevier Ltd.

Auteurs

Solenn Barraud (S)

Sorbonne Université, Department of Medical Oncology, Hôpital Saint-Antoine, AP-HP, and INSERM UMRS 938, Équipe Instabilité des Microsatellites et Cancer, Équipe Labellisée par la Ligue Nationale Contre le Cancer et SIRIC CURAMUS, Centre de recherche Saint Antoine, Paris, France.

David Tougeron (D)

Université de Poitiers, Faculté de Médecine et de Pharmacie and Department of Hepatology and Gastroenterology, Centre hospitalo-universitaire de Poitiers, Poitiers, France.

Laurent Villeneuve (L)

Clinical Research and Epidemiological Unit, Department of Public Health, Lyon University Hospital, EA 3738, University of Lyon, Lyon, France.

Clarisse Eveno (C)

Department of Digestive and Oncological Surgery, Claude Huriez University Hospital, and UMR- S1277- CANTHER Laboratory, "Cancer Heterogeneity, Plasticity and Resistance to Therapies", Lille, France.

Arnaud Bayle (A)

Drug Development Department (DITEP), Gustave Roussy, Villejuif, France; Oncostat U1018, Inserm, Université Paris-Saclay, Équipe Labellisée Ligue Contre le Cancer, Villejuif, France.

Yann Parc (Y)

Sorbonne Université, Department of Digestive Surgery, Hôpital Saint-Antoine, AP-HP, and INSERM UMRS 938, Équipe Instabilité des Microsatellites et Cancer, Équipe Labellisée par la Ligue Nationale Contre le Cancer et SIRIC CURAMUS, Centre de recherche Saint Antoine, Paris, France.

Marc Pocard (M)

Hepato-Biliary-Pancreatic Gastrointestinal Surgery and Liver Transplantation, Pitié-Salpêtrière Hospital, Assistance Publique/Hôpitaux de Paris, and Université Paris Cité, UMR INSERM 1275 CAP Paris-Tech, Lariboisière Hospital, F-75010 Paris, France.

Thierry André (T)

Sorbonne Université, Department of Medical Oncology, Hôpital Saint-Antoine, AP-HP, and INSERM UMRS 938, Équipe Instabilité des Microsatellites et Cancer, Équipe Labellisée par la Ligue Nationale Contre le Cancer et SIRIC CURAMUS, Centre de recherche Saint Antoine, Paris, France.

Romain Cohen (R)

Sorbonne Université, Department of Medical Oncology, Hôpital Saint-Antoine, AP-HP, and INSERM UMRS 938, Équipe Instabilité des Microsatellites et Cancer, Équipe Labellisée par la Ligue Nationale Contre le Cancer et SIRIC CURAMUS, Centre de recherche Saint Antoine, Paris, France. Electronic address: romain.cohen@aphp.fr.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Immune checkpoint inhibitors for patients with...
questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Utilisations thérapeutiques › Antinéoplasiques › Antinéoplasiques immunologiques › Inhibiteurs de points de contrôle immunitaires › Immune checkpoint inhibitors for patients with...
questionsmedicales.fr › Maladies de l'appareil digestif › Maladies du péritoine › Tumeurs du péritoine › Immune checkpoint inhibitors for patients with...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Immune checkpoint inhibitors for patients with...
questionsmedicales.fr › Maladies de l'appareil digestif › Maladies gastro-intestinales › Maladies intestinales › Tumeurs de l'intestin › Tumeurs du côlon › Immune checkpoint inhibitors for patients with...
questionsmedicales.fr › Maladies de l'appareil digestif › Maladies gastro-intestinales › Maladies intestinales › Maladies du rectum › Tumeurs colorectales › Immune checkpoint inhibitors for patients with...
questionsmedicales.fr › Phénomènes génétiques › Instabilité du génome › Instabilité des microsatellites › Immune checkpoint inhibitors for patients with...
questionsmedicales.fr › Phénomènes génétiques › Réparation de l'ADN › Réparation de mésappariement de l'ADN › Immune checkpoint inhibitors for patients with...