Advances and future perspectives of neoadjuvant immunotherapy in colorectal cancer
10.19401/j.cnki.1007-3639.2025.07.003
- VernacularTitle:结直肠癌新辅助免疫治疗的进展与展望
- Author:
Yuyang ZHANG
1
;
Qian LIU
1
Author Information
1. 国家癌症中心,国家肿瘤临床医学中心研究中心,中国医学科学院北京协和医学院肿瘤医院结直肠外科,北京 100021
- Publication Type:Journal Article
- Keywords:
Colorectal cancer;
Immunotherapy;
Neoadjuvant therapy;
Immune checkpoint inhibitor;
Biomarker
- From:
China Oncology
2025;35(7):642-656
- CountryChina
- Language:Chinese
-
Abstract:
In recent years,significant progress has been made in neoadjuvant immunotherapy for colorectal cancer(CRC),particularly demonstrating breakthrough efficacy in mismatch repair deficient/microsatellite instability-high(dMMR/MSI-H)subtypes.Immune checkpoint inhibitor(ICI)has achieved complete response(CR)rates as high as 41%-100%in this patient subgroup,driving the clinical adoption of"surgery-sparing"and"watch-and-wait"strategies.However,the majority of CRC patients with mismatch repair proficient/microsatellite stable(pMMR/MSS)tumors show limited response to ICI monotherapy,necessitating combination approaches with radiotherapy,chemotherapy,or targeted therapies to enhance efficacy.Current studies indicate that such combined regimens can elevate pathological complete response(pCR)rates to 22%-63%.Key research focuses include the synergistic effects of short-course radiotherapy(SCRT)combined with immunotherapy,the potential of dual-ICI therapy,and precision patient selection using biomarkers such as POLE/POLD1 mutations and tumor mutational burden(TMB).For treatment response assessment,the integration of colonoscopy,imaging,circulating tumor DNA(ctDNA)and artificial intelligence(AI)holds promise for optimizing clinical decision-making.Future efforts should prioritize immunomodulation strategies for pMMR/MSS patients,long-term safety evaluation of organ preservation approaches,and multidisciplinary collaboration to advance personalized therapy.Neoadjuvant immunotherapy is reshaping the CRC treatment paradigm,offering improved survival and quality of life for patients.
