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Efficacy of immunotherapy in patients with locally advanced colorectal cancer and microsatellite instability: a case series

https://doi.org/10.33878/2073-7556-2026-25-1-38-46

Abstract

AIM: to assess the efficacy of immunotherapy in patients with locally advanced CRC and MSI.

PATIENTS AND METHODS: three clinical cases of patients with locally advanced colorectal cancer and microsatellite instability are presented.

RESULTS: all three patients experienced major clinical and radiological improvement shortly after the start of ICI treatment. The third patient developed a 2nd degree immune-mediated pneumonitis that necessitated hormonal therapy and ICI termination. This patient got a subsequent laparoscopic right colectomy which proved complete pathomorphologic response. Recurrent-free survival since the beginning of ICI treatment is 54, 30 and 18 months, respectively.

CONCLUSION: patients with locally advanced CRC and MSI even in case of unresectability may benefit greatly after immunotherapy. This makes it crucial to evaluate the presence of MSI in this patients.

About the Authors

Oleg N. Zauzolkov
Moscow State Budgetary Healthcare Institution «Moscow City Hospital named S.S. Yudina, Moscow Healthcare Department»
Russian Federation

Durova st., 26, bld. 2, Moscow, 129090



Marina A. Lyadova
Moscow State Budgetary Healthcare Institution «Moscow City Hospital named S.S. Yudina, Moscow Healthcare Department»; Novokuznetsk State Institute for Postgraduate Medical Education — a branch of the Russian Medical Academy of Continuous Professional Education
Russian Federation

Durova st., 26, bld. 2, Moscow, 129090

Stroiteley Ave, 5, Novokuznetsk, 654005



Vladimir K. Lyadov
Moscow State Budgetary Healthcare Institution «Moscow City Hospital named S.S. Yudina, Moscow Healthcare Department»; Novokuznetsk State Institute for Postgraduate Medical Education — a branch of the Russian Medical Academy of Continuous Professional Education; Russian Medical Academy of Continuous Professional Education, Department of Oncology and Palliative Medicine named after Academician I.A. Savitsky
Russian Federation

Durova st., 26, bld. 2, Moscow, 129090

Stroiteley Ave, 5, Novokuznetsk, 654005

Barrikadnaya st., 2/1, bld. 1, Moscow, 125993



Denis S. Fedorinov
Moscow State Budgetary Healthcare Institution «Moscow City Hospital named S.S. Yudina, Moscow Healthcare Department»; Russian Medical Academy of Continuous Professional Education, Department of Oncology and Palliative Medicine named after Academician I.A. Savitsky
Russian Federation

Durova st., 26, bld. 2, Moscow, 129090

Barrikadnaya st., 2/1, bld. 1, Moscow, 125993



Evgeniya A. Kulikova
Moscow State Budgetary Healthcare Institution «Moscow City Hospital named S.S. Yudina, Moscow Healthcare Department»
Russian Federation

Durova st., 26, bld. 2, Moscow, 129090



Dmitrii V. Erygin
Moscow State Budgetary Healthcare Institution «Moscow City Hospital named S.S. Yudina, Moscow Healthcare Department»
Russian Federation

Durova st., 26, bld. 2, Moscow, 129090



Evgenii V. Ledin
Clinical Hospital №2 “Medsi Group of Companies”
Russian Federation

2nd Botkinsky proezd, 5, bld. 4, Moscow, 125284



Julia S. Mansurova
Moscow State Budgetary Healthcare Institution «Moscow City Hospital named S.S. Yudina, Moscow Healthcare Department»
Russian Federation

Durova st., 26, bld. 2, Moscow, 129090



References

1. Sung, H., Ferlay, J., Siegel, R.L., et al. (2021) Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA: A Cancer Journal for Clinicians, 71, 209-249. doi:10.3322/caac.21660

2. Lynch, H. T., Lynch, P. M., Lanspa, et al. (2009). Review of the Lynch syndrome: History, molecular genetics, screening, differential diagnosis, and medicolegal ramifications. Clinical Genetics, 76(1), 1-18. doi:10.1111/j.1399-0004.2009. 01230.x

3. Sinicrope FA, Sargent DJ. Molecular pathways: microsatellite instability in colorectal cancer: prognostic, predictive, and therapeutic implications. Clin Cancer Res. 2012 Mar 15;18(6):1506-12. doi: 10.1158/1078-0432.CCR-11-1469.

4. Le DT, Durham JN, Smith KN, et al (2017). Mismatch repair deficiency predicts response of solid tumors to PD-1 blockade. Science. 2017 Jul 28;357(6349):409-413. doi:10.1126/science. aan6733.

5. Fedyanin M.Yu., Gladkov O.A., Gordeev S.S., et al. Practical recommendations for drug treatment of cancer of the colon, rectosigmoid junction and rectum. Malignant tumors. 2022;12(3s2-1):401–454. (In Russ.). doi: 10.18027/2224-5057-2022-12-3s2-401-454.

6. Lyadova M.A., Nersesova T.A., Fedyanin M. Yu. Combined immunotherapy of colorectal cancer in young patients with microsatellite instability (clinical case). Medical alphabet. 2021; (10): 16–21. (In Russ.). doi:10.33667/2078-5631- 2021-10-16-21.

7. Oganyan K.A., Musaelyan A.A., Kotikova M.A., Lapin S.V., Nazarov V.D., Belyaev M.A., Zakharenko A.A., Orlov S.V. Molecular genetic characteristics of colorectal cancer depending on the status of microsatellite instability. Meditsinskiy Sovet. 2022;16(9):139–146. (In Russ.) doi:10.21518/2079-701X-2022-16-9-139-146.

8. Myriam Chalabi, Fanchi LF, Dijkstra KK., et al. Neoadjuvant immunotherapy leads to pathological responses in MMR-proficient and MMR-deficient early-stage colon cancers. Nat Med. 2020 Apr;26(4):566-576. doi: 10.1038/s41591-020-0805-8. Epub 2020 Apr 6. PMID: 32251400.

9. Rahma OE, Yothers G, Hong TS, Russell MM., et al. Use of Total Neoadjuvant Therapy for Locally Advanced Rectal Cancer: Initial Results from the Pembrolizumab Arm of a Phase 2 Randomized Clinical Trial. JAMA Oncol. 2021 Aug 1;7(8):1225-1230. doi: 10.1001/jamaoncol.2021.1683. Erratum in: JAMA Oncol. 2022 Jul 1;8(7):1073. doi: 10.1001/jamaoncol.2022.1721. PMID: 34196693; PMCID: PMC8251652.

10. Tsukada Y, Bando H, Inamori K, Wakabayashi M., et al. Three-year outcomes of preoperative chemoradiotherapy plus nivolumab in microsatellite stable and microsatellite instability-high locally advanced rectal cancer. Br J Cancer. 2024 Jul;131(2):283-289. doi: 10.1038/s41416-024-02730-7. Epub 2024 Jun 4. PMID: 38834744; PMCID: PMC11263387.

11. Myriam Chalabi, M.D., Ph.D., et al. (2024) Neoadjuvant Immunotherapy in Locally Advanced Mismatch Repair–Deficient Colon Cancer. N Engl J Med 2024; 390: 1949–1958гг. DOI: 10.1056/NEJMoa2400634

12. Andrea Cercek, M.D., Melissa Lumish, M.D., et al (2022) PD-1 Blockade in Mismatch Repair–Deficient, Locally Advanced Rectal Cancer N Engl J Med 2022;386:2363-2376 DOI: 10.1056/NEJMoa2201445


Review

For citations:


Zauzolkov O.N., Lyadova M.A., Lyadov V.K., Fedorinov D.S., Kulikova E.A., Erygin D.V., Ledin E.V., Mansurova J.S. Efficacy of immunotherapy in patients with locally advanced colorectal cancer and microsatellite instability: a case series. Koloproktologia. 2026;25(1):38-46. (In Russ.) https://doi.org/10.33878/2073-7556-2026-25-1-38-46

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ISSN 2073-7556 (Print)
ISSN 2686-7303 (Online)