Abstract
Immune checkpoint inhibitors (ICI) have high efficacy in metastatic colorectal cancer
(mCRC) with microsatellite instability (MSI) but not in microsatellite stable (MSS)
tumour due to the low tumour mutational burden. Selective internal radiation therapy
(SIRT) could enhance neoantigen production thus triggering systemic anti-tumoral immune
response (abscopal effect). In addition, Oxalipatin can induce immunogenic cell death
and Bevacizumab can decrease the exhaustion of tumour infiltrating lymphocyte. In
combination, these treatments could act synergistically to sensitize MSS mCRCs to
ICI
SIRTCI is a prospective, multicentre, open-label, phase II, non-comparative single-arm
study evaluating the efficacy and safety of SIRT plus Xelox, Bevacizumab and Atezolizumab
(anti-programmed death-ligand 1) in patients with liver-dominant MSS mCRC. The primary
objective is progression-free survival at 9 months. The main inclusion criteria are
patients with MSS mCRC with liver-dominant disease, initially unresectable disease
and with no prior oncologic treatment for metastatic disease. The trial started in
November 2020 and has included 10 out of the 52 planned patients.
Keywords
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Article info
Publication history
Published online: May 21, 2022
Accepted:
April 22,
2022
Received:
February 6,
2022
Identification
Copyright
© 2022 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
