Abstract
Background
Immune-Checkpoint-inhibitors (ICIs) are approved in first line therapy of microsatellite-instable,
deficient miss-match-repair (MSI-H-dMMR) metastatic colorectal cancer (mCRC), and
in second line after standard chemotherapy. Evidence supporting immunotherapy after
immunotherapy is scarce.
Case report
This case report highlights the course of a heavily pretreated patient with MSI-H
mCRC with progression after multiple local therapies, standard chemotherapies and
pembrolizumab. After 4 cycles of ipilimumab and nivolumab followed by nivolumab-maintenance
he achieved a long-lasting disease control of 22 months. After further subsequent
progression he regained immune mediated disease control by a second “boost” of ipilimumab.
Conclusion
Re-exposition with ipilimumab is a potential option to restore immune-mediated-disease-control
in patients with preceding long-lasting response to ipilimumab/nivolumab and with
dMMR-tumors. The clinical situation of progress after long-lasting disease control
on ICIs becomes more common and is an opportunity to investigate potential strategies
for restoring immune mediated disease control.
Keywords
List of Abbreviations:
mCRC (metastatic colorectal cancers), ICIs (Immune-Checkpoint Inhibitors), MSI-H (microsatellite instable high), dMMR (deficient mismatch repair)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: January 07, 2022
Accepted:
January 3,
2022
Received in revised form:
December 26,
2021
Received:
May 24,
2021
Footnotes
Editor: Dr E CCHU
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
