Durable Clinical Benefit after Dual Checkpoint Inhibition and Single-agent Nivolumab Following Pembrolizumab Failure in Mismatch Repair-deficient Colon Cancer
Immunotherapy with immune checkpoint inhibitors (ICIs) is beneficial in treating tumors with high microsatellite instability or DNA mismatch repair deficiency (dMMR) tumors. However, the ideal therapy for patients with advanced dMMR cancer after the failure of the first ICI regimen remains unclear....
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2023-10-01
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| Series: | Journal of Cancer Research and Practice |
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| Online Access: | https://journals.lww.com/10.4103/ejcrp.eJCRP-D-23-00027 |
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| author | Yat-Fung Chow Hou-Hsuan Cheng Ming-Huang Chen |
| author_facet | Yat-Fung Chow Hou-Hsuan Cheng Ming-Huang Chen |
| author_sort | Yat-Fung Chow |
| collection | DOAJ |
| description | Immunotherapy with immune checkpoint inhibitors (ICIs) is beneficial in treating tumors with high microsatellite instability or DNA mismatch repair deficiency (dMMR) tumors. However, the ideal therapy for patients with advanced dMMR cancer after the failure of the first ICI regimen remains unclear. This case report describes a patient with dMMR ascending colon cancer who later developed endometrial cancer. The patient underwent a sequence of immunotherapies, starting with pembrolizumab, followed by a combination of ipilimumab and nivolumab and finally single-agent nivolumab. This sequence led to a prolonged period of disease control exceeding 20 months. The case highlights the potential benefits of dual checkpoint inhibition and sequential ICI regimens in managing advanced dMMR tumors even after first-line ICI failure; this combination is a promising strategy to explore in future research. |
| format | Article |
| id | doaj-art-8b2c208a24f44b398f46d7e1c7d114f8 |
| institution | Kabale University |
| issn | 2311-3006 |
| language | English |
| publishDate | 2023-10-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Cancer Research and Practice |
| spelling | doaj-art-8b2c208a24f44b398f46d7e1c7d114f82025-01-23T05:09:00ZengWolters Kluwer Medknow PublicationsJournal of Cancer Research and Practice2311-30062023-10-0110414614910.4103/ejcrp.eJCRP-D-23-00027Durable Clinical Benefit after Dual Checkpoint Inhibition and Single-agent Nivolumab Following Pembrolizumab Failure in Mismatch Repair-deficient Colon CancerYat-Fung ChowHou-Hsuan ChengMing-Huang ChenImmunotherapy with immune checkpoint inhibitors (ICIs) is beneficial in treating tumors with high microsatellite instability or DNA mismatch repair deficiency (dMMR) tumors. However, the ideal therapy for patients with advanced dMMR cancer after the failure of the first ICI regimen remains unclear. This case report describes a patient with dMMR ascending colon cancer who later developed endometrial cancer. The patient underwent a sequence of immunotherapies, starting with pembrolizumab, followed by a combination of ipilimumab and nivolumab and finally single-agent nivolumab. This sequence led to a prolonged period of disease control exceeding 20 months. The case highlights the potential benefits of dual checkpoint inhibition and sequential ICI regimens in managing advanced dMMR tumors even after first-line ICI failure; this combination is a promising strategy to explore in future research.https://journals.lww.com/10.4103/ejcrp.eJCRP-D-23-00027colon cancerendometrial canceripilimumabmicrosatellite instabilitymismatch repair-deficientnivolumabpembrolizumab |
| spellingShingle | Yat-Fung Chow Hou-Hsuan Cheng Ming-Huang Chen Durable Clinical Benefit after Dual Checkpoint Inhibition and Single-agent Nivolumab Following Pembrolizumab Failure in Mismatch Repair-deficient Colon Cancer Journal of Cancer Research and Practice colon cancer endometrial cancer ipilimumab microsatellite instability mismatch repair-deficient nivolumab pembrolizumab |
| title | Durable Clinical Benefit after Dual Checkpoint Inhibition and Single-agent Nivolumab Following Pembrolizumab Failure in Mismatch Repair-deficient Colon Cancer |
| title_full | Durable Clinical Benefit after Dual Checkpoint Inhibition and Single-agent Nivolumab Following Pembrolizumab Failure in Mismatch Repair-deficient Colon Cancer |
| title_fullStr | Durable Clinical Benefit after Dual Checkpoint Inhibition and Single-agent Nivolumab Following Pembrolizumab Failure in Mismatch Repair-deficient Colon Cancer |
| title_full_unstemmed | Durable Clinical Benefit after Dual Checkpoint Inhibition and Single-agent Nivolumab Following Pembrolizumab Failure in Mismatch Repair-deficient Colon Cancer |
| title_short | Durable Clinical Benefit after Dual Checkpoint Inhibition and Single-agent Nivolumab Following Pembrolizumab Failure in Mismatch Repair-deficient Colon Cancer |
| title_sort | durable clinical benefit after dual checkpoint inhibition and single agent nivolumab following pembrolizumab failure in mismatch repair deficient colon cancer |
| topic | colon cancer endometrial cancer ipilimumab microsatellite instability mismatch repair-deficient nivolumab pembrolizumab |
| url | https://journals.lww.com/10.4103/ejcrp.eJCRP-D-23-00027 |
| work_keys_str_mv | AT yatfungchow durableclinicalbenefitafterdualcheckpointinhibitionandsingleagentnivolumabfollowingpembrolizumabfailureinmismatchrepairdeficientcoloncancer AT houhsuancheng durableclinicalbenefitafterdualcheckpointinhibitionandsingleagentnivolumabfollowingpembrolizumabfailureinmismatchrepairdeficientcoloncancer AT minghuangchen durableclinicalbenefitafterdualcheckpointinhibitionandsingleagentnivolumabfollowingpembrolizumabfailureinmismatchrepairdeficientcoloncancer |