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Overall survival of immunotherapy versus standard of care in chemorefractory microsatellite stable metastatic colorectal cancer: a propensity score matched analysis of 708 patients

Guglielmo Vetere, Emerik Osterlund, Mahmoud M G Yousef, Songwit Payapwattanawong, Giulia Maddalena, Jumanah Alshenaifi, Kristin D Alfaro, Mark Knafl, Van K Morris, Christine M Parseghian, Kanwal P S Raghav, Robert A Wolff, Arvind Dasari, Michael J Overman, Scott Kopetz, John Paul Shen

Journal for ImmunoTherapy of Cancer · 2026

Vollständiger Abstract

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Background Immune checkpoint inhibitors (ICIs) have limited efficacy in proficient mismatch repair/microsatellite stable (pMMR/MSS) metastatic colorectal cancer (mCRC). However, selected patients with specific metastatic patterns may derive benefit. Methods Patients with chemorefractory pMMR/MSS mCRC treated with ICI-based regimens were retrospectively identified. A comparison cohort treated with trifluridine/tipiracil±bevacizumab, regorafenib, or fruquintinib as standard of care (SOC) was generated through 1:1 propensity score matching by age, sex, Eastern Cooperative Oncology Group performance status (ECOG PS), liver metastases (present/absent), and RAS/BRAF status. Overall survival (OS) was compared using Cox regression. Results A total of 354 patients treated with ICIs and 354 treated with SOC were matched. Median age was 55 years, 52% male, 32% ECOG PS 0, 30% right-sided, and 69% RAS mutated in both groups, while 61% and 60% had liver metastases, respectively. Median OS (mOS) was 10.8 months with ICIs and 9.0 months with SOC (HR 0.76, 95% CI 0.64 to 0.92, p=0.004). In patients without liver metastases, mOS was longer with ICIs than SOC (19.1 vs 13.2 months, HR 0.59, 95% CI 0.43 to 0.80, p

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Autor:innen
Guglielmo Vetere, Emerik Osterlund, Mahmoud M G Yousef, Songwit Payapwattanawong, Giulia Maddalena, Jumanah Alshenaifi, Kristin D Alfaro, Mark Knafl, Van K Morris, Christine M Parseghian, Kanwal P S Raghav, Robert A Wolff, Arvind Dasari, Michael J Overman, Scott Kopetz, John Paul Shen
Quelle
Journal for ImmunoTherapy of Cancer
Publikation
2026-01-01
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ISSN / ISBN
2051-1426
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Guglielmo Vetere, Emerik Osterlund, Mahmoud M G Yousef, Songwit Payapwattanawong, Giulia Maddalena, Jumanah Alshenaifi, Kristin D Alfaro, Mark Knafl, Van K Morris, Christine M Parseghian, Kanwal P S Raghav, Robert A Wolff, Arvind Dasari, Michael J Overman, Scott Kopetz, John Paul Shen (2026). Overall survival of immunotherapy versus standard of care in chemorefractory microsatellite stable metastatic colorectal cancer: a propensity score matched analysis of 708 patients. Journal for ImmunoTherapy of Cancer. https://doi.org/10.1136/jitc-2026-015414
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