Cancer Chemotherapy and Pharmacology

, Volume 78, Issue 2, pp 247–247 | Cite as

Response from Drs. Formica/Zaniboni to Dr. Milano

  • V. Formica
  • A. ZaniboniEmail author
Letter to the Editor


Colorectal Cancer Molecular Basis Treatment Approach Cetuximab Combination Regimen 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

We would like to thank Dr. Milano et al. for the point they made on the possible role of drug-induced immune response occurring during treatment with either anti-VEGF or anti-EGFR agents [1].

We acknowledge the increasing importance that immune checkpoint inhibitors are gaining in the therapeutic armamentarium in oncology [2].

However, the impact of antitumor immunity, and in particular of PD-1/PD-L1-modulated immune response, is far to be fully elucidated in colorectal cancer.

Initial clinical data demonstrated no response with anti-PD-1 or anti-PD-L1 drugs in colorectal cancer [3, 4]. Subsequently, the clinical ‘niche’ (5–10 %) of microsatellite instable tumors was suggested to be sensitive to PD-1/PD-L1 targeting agents for this disease [5].

Moreover, the different biologic drugs in use for CRC patients may have different power in triggering an immune reaction, such as the NK-related antibody-dependent cellular cytotoxicity (ADCC), which is higher for the IgG2 cetuximab and lower for the IgG1 panitumumab, and this should be further taken into consideration [6].

We do strongly agree that combination regimens of anti-VEGF or anti-EGFR therapies with immunotherapies represent an extremely attractive new frontier; however, the molecular basis of such a treatment approach still needs to be accurately defined.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  1. 1.Medical Oncology DepartmentFondazione PoliambulanzaBresciaItaly
  2. 2.Medical Oncology UnitTor Vergata University HospitalRomeItaly

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