Abstract
Background
Although neoadjuvant immunotherapy is being widely studied, there is no consensus on its efficacy in microsatellite-stable (MSS) or mismatch repair proficient (pMMR) colorectal cancer (CRC). This meta-analysis aimed to evaluate studies on neoadjuvant immunotherapy for advanced CRC to assess its efficacy and provide new clinical guidelines.
Methods
We searched literature databases to identify studies that assessed the efficacy of neoadjuvant immunotherapy in advanced CRC. The outcomes evaluated were pathological complete response (pCR), major pathological response (MPR), R0 resection, and anal preservation rates. Heterogeneity among the included studies was assessed by sensitivity analysis, and publication bias was evaluated using Begg and Egger tests.
Results
Eleven articles were included in the analysis. The pCR, MPR, R0 resection, and anal preservation rates reported in these studies were 39 and 49, 97, and 76%, respectively. The MSI-H and MSS groups had pooled pCR rates of 70 and 24%, respectively. The pCR rates for the induction, consolidation, and concurrent immuno-chemoradiotherapy (CRT) subgroups were 43, 33, and 27%, respectively, and those for the single and double immunotherapy subgroups were 34 and 40%, respectively.
Conclusion
Neoadjuvant immunotherapy combined with CRT is effective in treating MSI-H/dMMR advanced CRC. It could also be a new first-line therapeutic option for MSS/pMMR advanced CRC.
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Data availability
The data underlying this article are available upon reasonable request to the corresponding author.
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All the authors contributed to manuscript writing, critical revision, and final review of the manuscript. YGL, CX, ZZ, HX, and KL contributed to the conception, design of the study, and critical revision of the manuscript. YGL and ZMG contributed to the data processing. YGL, CX, and ZZ were responsible for the study selection, data extraction, and quality assessment.
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Li, Y., Xue, C., Gao, Z. et al. Efficacy of neoadjuvant immunotherapy in advanced colorectal cancer: a meta-analysis of cross-sectional studies. J Cancer Res Clin Oncol 149, 4839–4846 (2023). https://doi.org/10.1007/s00432-022-04402-6
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DOI: https://doi.org/10.1007/s00432-022-04402-6