N Engl J Med

Dual immunotherapy shows promise in MSI-H metastatic colorectal cancer

December 3, 2024

Study design: This phase 3, open-label trial randomly assigned 303 patients with unresectable or metastatic colorectal cancer and microsatellite-instability-high (MSI-H) or mismatch-repair-deficient (dMMR) status to receive nivolumab plus ipilimumab, nivolumab alone, or chemotherapy with or without targeted therapies.

Results: At a median follow-up of 31.5 months, the combination of nivolumab plus ipilimumab significantly improved PFS compared with chemotherapy. The 24-month PFS rate was 72% with nivolumab plus ipilimumab vs. 14% with chemotherapy. Grade 3 or 4 treatment-related adverse events were less frequent in the nivolumab-plus-ipilimumab group (23%) compared with the chemotherapy group (48%).

Impact on clinical practice: Nivolumab combined with ipilimumab has the potential to become a preferred option for first-line treatment of MSI-H or dMMR metastatic colorectal cancer. This combination may provide a more effective and better-tolerated alternative to traditional chemotherapy.

Source:

Andre T, et al. (2024, November 28). N Engl J Med. Nivolumab plus Ipilimumab in Microsatellite-Instability-High Metastatic Colorectal Cancer. https://pubmed.ncbi.nlm.nih.gov/39602630/