Colon cancer immunotherapy successfully treats 5% to 10% of patients. How to select correct patients for colorectal cancer immunotherapy? What are key factors in cancer immunotherapy of colon cancer and rectal cancer?
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There is another option to kill cancer stem cells. Dr. Anton Titov, MD. It is probably more helpful and very recent method. It is immunotherapy. Immunotherapy is surprisingly active in other tumors. In kidney cancer or melanoma. Prof. Dr. Hans-Joachim Schmoll, MD. This is real immunotherapy. It means we let immune cells attack the tumor cells. Even when body’s own immune system was not working normally. Otherwise a tumor would not grow. T-cell checkpoint inhibitors can activate immune T-cells. Such toxic T-cells can kill the tumor. Immunotherapy works in many tumor types. It is very good last-line treatment. Now it is going to first-line therapy. Dr. Anton Titov, MD. But in colorectal cancer immunotherapy doesn’t work very well at the moment. We think the key is to select a specific subgroup of colon cancer patients. It is 5 to 10% of patients. It is important to let the immune cells do their work in the tumor cells and colon cancer stem cells. Prof. Dr. Hans-Joachim Schmoll, MD. I’m sure in few years the research will show how to use immunotherapy to kill colon cancer stem cells. But this is the optimal means to eliminate the tumor cells. Just by the activated normal human immune cells. it is also a question of selecting the right patients for immunotherapy. Those 5% – 10% of colon cancer patients. Immunotherapy might work for them even at the present level of technology. Dr. Anton Titov, MD. There is specific group of colon cancer patients for whom immunotherapy may work. These tumors have MSI characteristic. MSI is MicroSatellite Instability. MSI colon cancers have a particularly high mutation rate in the tumor. high mutation rate inside tumor attracts many immune T-cells into the tumor. T-cells are activated by immune checkpoint inhibitor medications. Prof. Dr. Hans-Joachim Schmoll, MD. Checkpoint inhibitors are antibodies for colorectal cancer treatment. Immune checkpoint inhibitors are very active in MSI-positive colorectal cancer. But these are only 5% to 15% of all colon cancers. It depends on the patient population. for the majority of colon cancer patients immune checkpoint inhibitors have no efficacy. We need to do more research on immunotherapy for colon cancer. We hope that immunotherapy research will bring results for patients in the near future. Thank you. [Immune checkpoint inhibitors: Keytruda , Yervoy , Opdivo , Ofatumumab Arzerra, Rituximab, Rituxan, Mabthera]. Leading colorectal cancer oncologist and research expert discusses colon cancer diagnosis and treatment options. Colorectal cancer immunotherapy advances. Which patients benefit from immunotherapy? Colon cancer immunotherapy has to achieve better success rate. Immune checkpoint inhibitors can activate immune T-cells to kill colon cancer stem cells. Immune checkpoint inhibitors: Keytruda (pembrolizumab), Yervoy (ipilimumab), Opdivo (nivolumab), Ofatumumab Arzerra, Rituximab, Rituxan, Mabthera. Immunotherapy might work for 5% or 10% of colorectal cancer patients even at the present level of technology. Immune checkpoint inhibitors are very active in MSI-positive colorectal cancer. Microsatellite instability happens in 15% of colorectal cancer. Cancer immunotherapy takes aim at tumors with many mutations.