Impact of treatment discontinuation among patients with microsatellite instability or mismatch repair-deficient metastatic colorectal cancer treated with immune checkpoint inhibitors
Some advanced colon-cancer patients safely stop immunotherapy when blood tests show no tumor DNA, potentially avoiding unnecessary long-term treatment.
In 84 MSI/dMMR mCRC patients with median 48-month follow-up, stopping ICI treatment for reasons other than progression did not compromise survival outcomes, and ctDNA negativity at ICI discontinuation predicted durable remission (7% progression rate). These findings support selective ICI de-escalation guided by liquid biopsy, though the retrospective design warrants prospective validation.
What the study was
- Study design
- Retrospective cohort study
- Population
- MSI/dMMR metastatic colorectal cancer patients treated with ICIs; Spain and Italy (VHIO, IOV-IRCCS)
- Sample size
- 84
- Category
- Treatment Innovation
- Maturity
- Exploratory
- Journal
- ESMO Open
Why it surfaced
Real-world ctDNA data to guide ICI de-escalation in MSI/dMMR mCRC — a population with growing treatment exposure. The ctDNA-negative stopping criterion is immediately actionable if prospectively confirmed; important for reducing toxicity and cost.
A plain-language summary of published research — not medical advice. Talk to a clinician about your own care.