Author:
San-Román-Gil María,Martínez-Delfrade Iñigo,Albarrán-Fernández Víctor,Guerrero-Serrano Patricia,Pozas-Pérez Javier,Chamorro-Pérez Jesús,Rosero-Rodríguez Diana,Sotoca-Rubio Pilar,Barrill-Corpa Ana Maria,Alia-Navarro Víctor,González-Merino Carlos,García-de-Quevedo-Suero Coral,López Victoria,Ruz-Caracuel Ignacio,Perna-Monroy Cristian,Ferreiro-Monteagudo Reyes
Abstract
Immunotherapy has demonstrated a role in the therapeutic landscape of a small subset of patients with colorectal carcinoma (CRC) that harbor a microsatellite instability (MSI-H) status due to a deficient DNA mismatch repair (dMMR) system. The remarkable responses to immune checkpoint inhibitors (ICIs) are now being tested in the neoadjuvant setting in localized CRC, where the dMMR/MSI-H status can be found in up to 15% of patients, with remarkable results obtained in NICHE2 and 3 trials, among others. This case series aims to report our experience at a tertiary center and provide a comprehensive analysis of the possible questions and challenges to overcome if ICIs were established as standard of care in a neoadjuvant setting, as well as the potential role they may have as conversion therapy not only in locoregional advanced CRC but also in oligometastatic disease.