Efficacy of neoadjuvant immunotherapy in advanced colorectal cancer: a meta-analysis of cross-sectional studies

Background Although neoadjuvant immunotherapy is being widely studied, there is no consensus on its efficacy in microsatellite-stable (MSS) or mismatch repair proficient (pMMR) colorectal cancer (CRC). This meta-analysis aimed to evaluate studies on neoadjuvant immunotherapy for advanced CRC to asse...

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Bibliographic Details
Published in:Journal of cancer research and clinical oncology 2023-07, Vol.149 (8), p.4839-4846
Main Authors: Li, Yuegang, Xue, Chi, Gao, Ziming, Li, Kai, Xu, Huimian, Zhu, Zhi
Format: Article
Language:English
Subjects:
Cancer Research
Chemoradiotherapy
Colorectal cancer
Colorectal carcinoma
Cross-sectional studies
Hematology
Immunotherapy
Internal Medicine
Medicine
Medicine & Public Health
Meta-analysis
Mismatch repair
Oncology
Preservation
Sensitivity analysis
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Summary:Background Although neoadjuvant immunotherapy is being widely studied, there is no consensus on its efficacy in microsatellite-stable (MSS) or mismatch repair proficient (pMMR) colorectal cancer (CRC). This meta-analysis aimed to evaluate studies on neoadjuvant immunotherapy for advanced CRC to assess its efficacy and provide new clinical guidelines. Methods We searched literature databases to identify studies that assessed the efficacy of neoadjuvant immunotherapy in advanced CRC. The outcomes evaluated were pathological complete response (pCR), major pathological response (MPR), R0 resection, and anal preservation rates. Heterogeneity among the included studies was assessed by sensitivity analysis, and publication bias was evaluated using Begg and Egger tests. Results Eleven articles were included in the analysis. The pCR, MPR, R0 resection, and anal preservation rates reported in these studies were 39 and 49, 97, and 76%, respectively. The MSI-H and MSS groups had pooled pCR rates of 70 and 24%, respectively. The pCR rates for the induction, consolidation, and concurrent immuno-chemoradiotherapy (CRT) subgroups were 43, 33, and 27%, respectively, and those for the single and double immunotherapy subgroups were 34 and 40%, respectively. Conclusion Neoadjuvant immunotherapy combined with CRT is effective in treating MSI-H/dMMR advanced CRC. It could also be a new first-line therapeutic option for MSS/pMMR advanced CRC.
ISSN:0171-5216
1432-1335
DOI:10.1007/s00432-022-04402-6