Efficacy and safety of radiotherapy combined with anti‐angiogenic therapy and immune checkpoint inhibitors in MSS/pMMR metastatic colorectal cancer
Abstract Purpose Several studies have demonstrated the effectiveness of anti‐angiogenic drugs in combination with immune checkpoint inhibitors (ICIs) in patients with microsatellite stable (MSS) or mismatch repair proficient (pMMR) metastatic colorectal cancer (mCRC). However, whether combination ra...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2024-01-01
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| Series: | Cancer Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/cam4.6820 |
| _version_ | 1797277133707411456 |
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| author | Menglan Zhai Zixuan Zhang Haihong Wang Jinghua Ren Sheng Zhang Mingjie Li Lichao Liu Lisha Li Lan Zhang Xin Li Tao Zhang Zhenyu Lin |
| author_facet | Menglan Zhai Zixuan Zhang Haihong Wang Jinghua Ren Sheng Zhang Mingjie Li Lichao Liu Lisha Li Lan Zhang Xin Li Tao Zhang Zhenyu Lin |
| author_sort | Menglan Zhai |
| collection | DOAJ |
| description | Abstract Purpose Several studies have demonstrated the effectiveness of anti‐angiogenic drugs in combination with immune checkpoint inhibitors (ICIs) in patients with microsatellite stable (MSS) or mismatch repair proficient (pMMR) metastatic colorectal cancer (mCRC). However, whether combination radiotherapy (RT) can further improve the prognosis of mCRC patients after second‐line treatment remains to be explored. Methods Retrospective analysis of data from mCRC patients who received anti‐angiogenic targeted therapy (TT) and immunotherapy (IT) with or without RT after the failure of standard therapy. Progression‐free survival (PFS), overall survival (OS), objective response rate (ORR), disease control rate (DCR), and safety were evaluated. Results A total of 82 patients who received TT + IT were analyzed. For RT group (n = 42) versus NRT group (n = 40), ORR was 21.4% (9/42) versus 5.0% (2/40); DCR was 83.8% (35/42) versus 65.0% (26/40). Compared with NRT group, RT improved PFS (median: 5.0 vs. 3.6 months; p = 0.04) and OS (median: 15.2 vs. 7.2 months; p = 0.01). In addition, in the population receiving RT, the PFS of RT sequential/simultaneous TT + IT was superior to TT + IT sequential RT (median: 7.1 vs. 6.2 vs. 3.5 months, p = 0.004). Multivariate analysis suggested RT was an independent prognostic factor for PFS and OS. No treatment‐related deaths were reported. Conclusions Compared with TT + IT, RT combined with TT + IT improved survival outcomes in MSS/pMMR mCRC patients, with manageable toxicity. RT sequential/simultaneous TT + IT treatment is expected to be the optimal strategy for MSS/PMMR mCRC. |
| first_indexed | 2024-03-07T15:43:17Z |
| format | Article |
| id | doaj.art-26270b1383f747118ce4203ae7791beb |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-03-07T15:43:17Z |
| publishDate | 2024-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-26270b1383f747118ce4203ae7791beb2024-03-05T06:22:52ZengWileyCancer Medicine2045-76342024-01-01131n/an/a10.1002/cam4.6820Efficacy and safety of radiotherapy combined with anti‐angiogenic therapy and immune checkpoint inhibitors in MSS/pMMR metastatic colorectal cancerMenglan Zhai0Zixuan Zhang1Haihong Wang2Jinghua Ren3Sheng Zhang4Mingjie Li5Lichao Liu6Lisha Li7Lan Zhang8Xin Li9Tao Zhang10Zhenyu Lin11Cancer Center, Union Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan ChinaQueen Mary School, Medical Department Nanchang University Nanchang Jiangxi ChinaCancer Center, Union Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan ChinaCancer Center, Union Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan ChinaCancer Center, Union Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan ChinaCancer Center, Union Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan ChinaCancer Center, Union Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan ChinaCancer Center, Union Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan ChinaDepartment of Radiology Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan ChinaDepartment of Radiology Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan ChinaCancer Center, Union Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan ChinaCancer Center, Union Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan ChinaAbstract Purpose Several studies have demonstrated the effectiveness of anti‐angiogenic drugs in combination with immune checkpoint inhibitors (ICIs) in patients with microsatellite stable (MSS) or mismatch repair proficient (pMMR) metastatic colorectal cancer (mCRC). However, whether combination radiotherapy (RT) can further improve the prognosis of mCRC patients after second‐line treatment remains to be explored. Methods Retrospective analysis of data from mCRC patients who received anti‐angiogenic targeted therapy (TT) and immunotherapy (IT) with or without RT after the failure of standard therapy. Progression‐free survival (PFS), overall survival (OS), objective response rate (ORR), disease control rate (DCR), and safety were evaluated. Results A total of 82 patients who received TT + IT were analyzed. For RT group (n = 42) versus NRT group (n = 40), ORR was 21.4% (9/42) versus 5.0% (2/40); DCR was 83.8% (35/42) versus 65.0% (26/40). Compared with NRT group, RT improved PFS (median: 5.0 vs. 3.6 months; p = 0.04) and OS (median: 15.2 vs. 7.2 months; p = 0.01). In addition, in the population receiving RT, the PFS of RT sequential/simultaneous TT + IT was superior to TT + IT sequential RT (median: 7.1 vs. 6.2 vs. 3.5 months, p = 0.004). Multivariate analysis suggested RT was an independent prognostic factor for PFS and OS. No treatment‐related deaths were reported. Conclusions Compared with TT + IT, RT combined with TT + IT improved survival outcomes in MSS/pMMR mCRC patients, with manageable toxicity. RT sequential/simultaneous TT + IT treatment is expected to be the optimal strategy for MSS/PMMR mCRC.https://doi.org/10.1002/cam4.6820immunotherapymetastatic colorectal cancermicrosatellite stableradiotherapytargeted therapy |
| spellingShingle | Menglan Zhai Zixuan Zhang Haihong Wang Jinghua Ren Sheng Zhang Mingjie Li Lichao Liu Lisha Li Lan Zhang Xin Li Tao Zhang Zhenyu Lin Efficacy and safety of radiotherapy combined with anti‐angiogenic therapy and immune checkpoint inhibitors in MSS/pMMR metastatic colorectal cancer Cancer Medicine immunotherapy metastatic colorectal cancer microsatellite stable radiotherapy targeted therapy |
| title | Efficacy and safety of radiotherapy combined with anti‐angiogenic therapy and immune checkpoint inhibitors in MSS/pMMR metastatic colorectal cancer |
| title_full | Efficacy and safety of radiotherapy combined with anti‐angiogenic therapy and immune checkpoint inhibitors in MSS/pMMR metastatic colorectal cancer |
| title_fullStr | Efficacy and safety of radiotherapy combined with anti‐angiogenic therapy and immune checkpoint inhibitors in MSS/pMMR metastatic colorectal cancer |
| title_full_unstemmed | Efficacy and safety of radiotherapy combined with anti‐angiogenic therapy and immune checkpoint inhibitors in MSS/pMMR metastatic colorectal cancer |
| title_short | Efficacy and safety of radiotherapy combined with anti‐angiogenic therapy and immune checkpoint inhibitors in MSS/pMMR metastatic colorectal cancer |
| title_sort | efficacy and safety of radiotherapy combined with anti angiogenic therapy and immune checkpoint inhibitors in mss pmmr metastatic colorectal cancer |
| topic | immunotherapy metastatic colorectal cancer microsatellite stable radiotherapy targeted therapy |
| url | https://doi.org/10.1002/cam4.6820 |
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