A new study offers hope for patients with locally advanced colon cancer characterized by mismatch repair deficiency (dMMR). The NICHE-3 trial has demonstrated remarkable success using a novel immunotherapy combination before surgery.
Key Findings
Impressive Response Rates
The study, involving 59 patients with dMMR colon cancer, used a combination of two immunotherapy drugs:
- Nivolumab (anti-PD-1)
- Relatlimab (anti-LAG-3)
This treatment resulted in:
- 97% of patients showing a pathologic response
- 92% achieving major pathologic responses (≤10% residual viable tumor)
- 68% experiencing complete pathologic responses (no detectable cancer)
Safety Profile
The treatment was generally well-tolerated:
- 80% of patients experienced some side effects
- Only 10% had severe (grade 3-4) immune-related adverse events
Common side effects included infusion-related reactions, thyroid dysfunction, and fatigue.
Implications for Patients
This study adds to growing evidence supporting the use of immunotherapy before surgery (neoadjuvant treatment) in dMMR colon cancer. The combination of nivolumab and relatlimab appears to be highly effective in shrinking tumors prior to surgical removal.
Looking Ahead
While these results are promising, the researchers emphasize the need for larger studies to confirm the findings. The long-term outcomes and potential impact on survival rates will require further investigation. Patients with locally advanced dMMR colon cancer should discuss with their oncologists whether they might be candidates for similar immunotherapy approaches in clinical trials or as part of their treatment plan.
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Reference
de Gooyer, P.G.M., Verschoor, Y.L., van den Dungen, L.D.W. et al. Neoadjuvant nivolumab and relatlimab in locally advanced MMR-deficient colon cancer: a phase 2 trial. Nat Med (2024). https://doi.org/10.1038/s41591-024-03250-w
