Evidence map›Paper›PMID 42026473›Full record

ArticleBMC gastroenterology2026

Immune checkpoint inhibitor resistance in dMMR high-grade intraepithelial neoplasia with lynch syndrome-associated colon cancer: a case report.

Liping Liu, Ling Zhou, Hongjiao Zhang, Yan He, Juanjuan Zhou, Yi Le, Weiqi Liu, Jinbo Zhan, Ziling Fang, Li Li and 1 more

Abstract readCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC gastroenterology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Liping Liu *Department of Oncology, The First Affiliated Hospital of Nanchang University, Nanchang, People's Republic of China.
Ling Zhou *Department of Oncology, The First Affiliated Hospital of Nanchang University, Nanchang, People's Republic of China.
Hongjiao Zhang *Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical Sciences, Jinan, People's Republic of China.
Yan HeDepartment of Oncology, The First Affiliated Hospital of Nanchang University, Nanchang, People's Republic of China.
Juanjuan ZhouDepartment of Oncology, The First Affiliated Hospital of Nanchang University, Nanchang, People's Republic of China.
Yi LeDepartment of Oncology, The First Affiliated Hospital of Nanchang University, Nanchang, People's Republic of China.
Weiqi LiuDepartment of Oncology, The First Affiliated Hospital of Nanchang University, Nanchang, People's Republic of China.
Jinbo ZhanDepartment of Oncology, The First Affiliated Hospital of Nanchang University, Nanchang, People's Republic of China.
Ziling FangDepartment of Oncology, The First Affiliated Hospital of Nanchang University, Nanchang, People's Republic of China. zfang916@126.com.
Li Li *Department of Oncology, The First Affiliated Hospital of Nanchang University, Nanchang, People's Republic of China. lili@email.ncu.edu.cn.
Xiaojun XiangDepartment of Oncology, The First Affiliated Hospital of Nanchang University, Nanchang, People's Republic of China. xjxiang_nc@ncu.edu.cn.

Funding

the "Double Thousand" project for training high-level talents of scientific and technological innovation in Jiangxi Province jxsq2023201038the National Natural Science Foundation of China 82160464the Natural Science Foundation of Jiangxi Province 20242BAB26146
6 · The paper itself

Abstract

backgroundImmune checkpoint inhibitors demonstrate high efficacy in MSI-H/dMMR colorectal cancer, yet a subset of patients develops resistance. This case reports in situ recurrence in Lynch syndrome-associated colon cancer, with the novel observation that while the recurrent lesion responded completely to immunotherapy, a concurrent dMMR ascending colon adenoma showed resistance. CASE PRESENTATION: A patient with Lynch syndrome-associated colon cancer experienced in situ recurrence. Immunotherapy led to complete response in the recurrent lesion, but the coexisting dMMR ascending colon adenoma failed to respond. Multiplex immunofluorescence and whole-exome sequencing revealed high CD68+ macrophage infiltration, low CD8+ T cells, CD20+ B cells, and CD56+ NK cells in the adenoma, along with mutations in NRAS, CTNNB1, HLA-DQB1/DRB1/DRB5, VEGFA, TGFBI, PTGS2, and others.

conclusionThis case highlights marked heterogeneity in immunotherapy responses among dMMR colorectal cancer patients. Even sustained responders require ongoing colonoscopic surveillance and polypectomy when indicated, particularly those with a history of polyps. Tumor microenvironment features and specific mutations may contribute to immune escape.

Indexed as

AdenomaCarcinoma in SituColonic NeoplasmsColorectal Neoplasms, Hereditary NonpolyposisDrug Resistance, NeoplasmImmune Checkpoint InhibitorsFemaleHumansMaleMiddle AgedNeoplasm Recurrence, LocalTumor MicroenvironmentImmune Checkpoint InhibitorsColon adenomaColorectal cancerImmunotherapy resistanceLynch syndromeTumor microenvironment

Identifiers

PMID42026473
PMCPMC13238101

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.