Abstract
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.
Keywords
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Article info
Publication history
Published online: October 18, 2022
Accepted:
September 23,
2022
Received:
August 5,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
