Long-term follow-up needed

After reviewing this study, Anton Bilchik, MD, PhD, surgical oncologist, chief of medicine, and director of the Gastrointestinal and Hepatobiliary Program at Providence Saint John’s Cancer Institute in Santa Monica, CA, told MNT he found the study to be very interesting because this is the first time that immunotherapy has been studied in these stages of colon cancer given before surgery.

“It’s well known that immunotherapy given in patients with advanced colon cancer that have high microsatellite instability have an up to 80-90% response, so this is the first time it’s been looked at in people who typically undergo an operation and then after the operation and evaluation of the lymph nodes, the determination is made whether to get chemotherapy or not,” Bilchik continued.

“And this study shows that a high percentage of patients in that earliest stage — so we’re talking about stage two or three — that get immunotherapy before surgery, 50% of them had no tumor in the specimen, and that makes the study very novel and provocative.”
— Anton Bilchik, MD, PhD

MNT also spoke with Glenn S. Parker, MD, FACS, FASCRS, vice chairman of surgery and chief of the Division of Colon and Rectal Surgery at Hackensack Meridian Jersey Shore University Medical Center in New Jersey, who commented that these promising results of immunotherapy cannot be translated to treat all colon cancers and long-term follow up is needed to assess the duration of response.

“However, as more drugs for both chemotherapy and immunotherapy are developed on the horizon, additional clinical trials will continue to play a role in the molecular genetic profile for individual patients, their tumors, and greater precision medicine in the future,” Parker said.