Related Experiment Video
Updated: Oct 19, 2025
Establishment of a Co-culture System of Patient-Derived Colorectal Tumor Organoids and Tumor-Infiltrating Lymphocytes (TILs)
Published on: June 27, 2025
Application of immune checkpoint inhibitors in colorectal cancer
1Department of Oncology, Third Xiangya Hospital, Central South University, Changsha 410013, China. 2811435648@qq.com.
Abstract:
Over the past decade, immunotherapy has been shown to have antitumor activity in a variety of solid tumors, such as melanoma, renal cell carcinoma, and non-small cell lung cancer, keeping a lead in a new era of tumor immunotherapy. Colorectal cancer with high microsatellite instability (MSI-H) or mismatch repair deficient (dMMR) is sensitive to immune checkpoint inhibitors (ICIs). ICIs monotherapy and ICIs combination therapy have made breakthroughs in the treatment of MSI-H/dMMR CRC. At present, a variety of ICIs have been approved for first- and post-line treatment in patients with CRC. However, MSI-H/dMMR type tumors only account for 5% of metastatic CRC, and the most CRCs were microsatellite stable (MSS) or mismatch repair proficient (pMMR). Many clinical trials are exploring effective treatments for patients with MSS/pMMR CRC, and the combination of ICIs and drugs with different mechanisms is expected to improve the efficacy of MSS/pMMR CRC patients. In the future, attention should be paid to finding the potential therapeutic markers of ICIs and the drug resistance mechanism of ICIs, so as to break through the immune tolerance of MSS/pMMR CRC patients.
Insights
Immunotherapy, including immune checkpoint inhibitors (ICIs), shows promise for colorectal cancer (CRC). While effective for high microsatellite instability (MSI-H) CRC, new strategies are needed for microsatellite stable (MSS) CRC.
Area of Science:
- Oncology
- Immunology
- Cancer Research
Background:
- Immunotherapy, particularly immune checkpoint inhibitors (ICIs), has revolutionized solid tumor treatment.
- High microsatellite instability (MSI-H) or mismatch repair deficient (dMMR) colorectal cancer (CRC) demonstrates sensitivity to ICIs.
- ICIs have achieved significant success in treating MSI-H/dMMR CRC, with several agents approved.
Purpose of the Study:
- To review the current landscape of immunotherapy in colorectal cancer.
- To highlight the challenges and opportunities in treating microsatellite stable (MSS) or mismatch repair proficient (pMMR) CRC.
- To discuss future directions for improving ICI efficacy in MSS/pMMR CRC.
Main Methods:
- Review of current clinical data and research on immunotherapy for colorectal cancer.
- Analysis of treatment outcomes for MSI-H/dMMR CRC versus MSS/pMMR CRC.
- Exploration of emerging therapeutic strategies and biomarkers.
Main Results:
- ICIs offer effective treatment options for MSI-H/dMMR CRC.
- MSS/pMMR CRC, representing the majority of cases, remains a challenge for current immunotherapies.
- Combination therapies and identification of novel therapeutic markers are under investigation for MSS/pMMR CRC.
Conclusions:
- While immunotherapy has advanced CRC treatment, particularly for MSI-H/dMMR subtypes, significant unmet needs exist for MSS/pMMR patients.
- Future research should focus on overcoming immune tolerance in MSS/pMMR CRC and identifying predictive biomarkers for ICI therapy.
- Combination strategies hold promise for enhancing treatment efficacy in the broader CRC population.
Related Concept Videos
01:27Tumor Immunotherapy
01:29Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
01:29Drugs for Treatment of Ulcerative Colitis in IBD