ArticleESMO open2026
Immune checkpoint blockade in locally advanced rectal cancer with deficient DNA mismatch repair: retrospective multicenter experience.
Article in ESMO open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Paradigm Shifts in Perioperative Management of Colorectal Cancer: Personalization Based on Tumor Biology, Primary Site, and Recurrence Risk, and the Evolving Role of Organ Preservation.International journal of molecular sciences · 2026Review
- Lynch Syndrome as a Spectrum of Four Distinct Genetic Disorders: Toward Genotype-Guided Precision Management in the NGS Era.Cancers · 2026Review
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12 authors.
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Abstract
backgroundProspective, single-institution studies in deficient DNA mismatch repair (dMMR) locally advanced rectal cancer (LARC) have shown high rates of complete clinical response (cCR) to neoadjuvant immune checkpoint inhibitor (ICI) monotherapy. PATIENTS AND
methodsWe conducted a multisite, retrospective, and cross-sectional analysis of dMMR LARC patients (N = 21) treated at four academic medical centers. The objective response rate (ORR) after neoadjuvant ICI treatment was assessed by sequential pelvic magnetic resonance imaging scans and flexible sigmoidoscopy. Clinical variables analyzed included tumor-node-metastasis stage (I-III), rectal tumor location (proximal, mid, and distal), and sporadic dMMR or Lynch syndrome.
resultsThe median age of patients was 46 years; 71% were male. Tumors (N = 21) were staged as III (n = 15), II (n = 3), I (n = 2), and 1 unknown (T4NxM0). Twenty patients received anti-programmed cell death protein 1 (anti-PD-1) monotherapy; one received combined anti-PD-1 and anti-cytotoxic T-lymphocyte-associated protein 4 (anti-CTLA-4) treatment. The median duration of ICI treatment was 7 months (range 2-23 months). The ORR was 85.7% [95% confidence interval (CI) 63.7% to 97.0%], which includes 11 (52.4%; 95% CI 29.8% to 74.3%) cCRs and 7 (33.3%; 95% CI 14.6% to 57.0%) partial responses. Stable disease was achieved in 1 (4.8%) patient (95% CI 0.1% to 23.8%) and progressive disease in 2 (9.5%) patients (95% CI 1.2% to 30.4%). Among 18 patients with any clinical response, the median time to best clinical response was 6 months (interquartile range 4.2-7.7 months). Salvage chemoradiation therapy and surgery were carried out in 9 of 10 patients with an incomplete clinical response. The 1- and 2-year disease-free survival rates were 100% (95% CI 85.7% to 100%) and 87% (95% CI 72% to 100%), respectively.
conclusionNeoadjuvant ICI therapy for dMMR LARC produced cCRs in at least half of patients. These real-world data support the feasibility of nonoperative management, but the observed heterogeneity in clinical response highlights the need to optimize patient selection and monitoring strategies.
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