Redefining curative treatment for early-stage mismatch repair-deficient colon cancer
Mené aux Pays-Bas à partir de données portant sur 123 patients atteints d'un cancer du côlon présentant une déficience du système de réparation des mésappariements de l'ADN et de stade avancé, cet essai multicentrique de phase II évalue l'efficacité, du point de vue de la survie sans maladie à 3 ans et de la survie globale à 5 ans, d'une immunothérapie néoadjuvante combinant ipilimumab et nivolumab
For decades, the standard of care for patients with resected stage II and III colon cancer has centred on surgery with consideration of postoperative adjuvant systemic therapy to reduce risk of recurrence. Mismatch repair deficiency is seen in 10–15% of non-metastatic colon cancers and is predictive of response to immune checkpoint inhibition. The initial report of the single-arm, phase 2 NICHE-2 study of one dose of ipilimumab (1 mg per kg) and two doses of nivolumab (3 mg per kg) before surgery with clinical stage II and III colon cancer generated considerable interest after demonstrating a remarkable 98% pathologic response rate, including a pathologic complete response rate of 68%.1 The question remained as to whether these findings would translate into durable improvements in survival.
The Lancet , commentaire, 2026