100% 3-Year Survival in dMMR Colon Cancer with Neoadjuvant Immunotherapy | ESMO 2024
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100% 3-Year Survival in dMMR Colon Cancer with Neoadjuvant Immunotherapy | ESMO 2024
Approximately 10% to 15% of patients with non-metastatic colon cancer have mismatch repair deficiency (dMMR), and these patients gain limited benefit from standard chemotherapy, with a 3-year recurrence rate of up to 40%. Previous studies of neoadjuvant immunotherapy have shown promising results.
The NICHE-2 trial explored the efficacy and safety of nivolumab plus ipilimumab in patients with non-metastatic, locally advanced dMMR colon cancer.
The results revealed a pathologic complete response (pCR) rate of 68% and a major pathologic response (MPR) rate of 95%. These findings, published in the New England Journal of Medicine (NEJM), have garnered widespread clinical attention.
At the 2024 European Society for Medical Oncology (ESMO) annual meeting in Barcelona, Spain, Professor Myriam Chalabi from the Netherlands Cancer Institute presented previously unpublished 3-year disease-free survival (DFS) data from the NICHE-2 trial. The results were remarkable: all patients survived without recurrence, with a 3-year DFS rate of 100%.
ESMO is one of the most prestigious and influential conferences in the oncology field, featuring breakthroughs in basic, translational, and clinical research. This year’s conference included updates on 83 studies across 18 topics, including non-small cell lung cancer, gastrointestinal tumors, breast cancer, and urological cancers.
The NICHE-2 trial enrolled patients with non-metastatic, locally advanced, untreated dMMR colon cancer. Patients received nivolumab plus ipilimumab on day 1, followed by another dose of nivolumab on day 15. Surgery was performed six weeks later. The primary endpoint was a 3-year DFS rate exceeding 93%. Researchers used circulating tumor DNA (ctDNA) testing at baseline, on day 15 of treatment, before surgery, and three weeks post-surgery to detect minimal residual disease (MRD). If ctDNA was undetectable, it indicated no remaining cancer cells in the body.
After a median follow-up of 36.5 months, all 111 patients remained alive without any recurrence, achieving a 100% 3-year DFS rate.
At baseline, ctDNA was detected in 92% of patients. By day 15 of treatment, this dropped to 45%. Further analysis of patients who achieved pCR and MPR showed no difference in ctDNA detection at baseline, but by day 15 and before surgery, ctDNA levels were significantly lower in the pCR group compared to the MPR group. Before surgery, 94% of patients in the pCR group and 70% in the MPR group had undetectable ctDNA. Although 16 patients still had detectable ctDNA before surgery, all tested negative for ctDNA three weeks post-surgery.
In conclusion, the updated data shows that neoadjuvant therapy for dMMR colon cancer patients resulted in a 100% 3-year DFS rate.
100% 3-Year Survival in dMMR Colon Cancer with Neoadjuvant Immunotherapy | ESMO 2024
Sources:
- Myriam Chalabi. LBA24 – Neoadjuvant immunotherapy in locally advanced MMR-deficient colon cancer: 3-year disease-free survival from NICHE-2. ESMO 2024
- Chalabi M, Verschoor YL, Tan PB, et al. Neoadjuvant Immunotherapy in Locally Advanced Mismatch Repair-Deficient Colon Cancer. N Engl J Med. 2024;390(21):1949-1958. doi: 10.1056/NEJMoa2400634.
(source:internet, reference only)
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