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Colorectal cancers, immunotherapy is one more weapon

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Immunotherapy DRUGS have revolutionized the treatment and prognosis of a small percentage, about 5%, of colon cancers: those that have a specific molecular characteristic, called microsatellite instability. A feature that makes the tumor “inflamed”, so much so that it stimulates the T lymphocytes, the “effector” cells of the immune response, against the tumor, making it sensitive to immunotherapy. The remaining 95% of patients, however, are not “inflamed” and therefore do not respond to this treatment. Is it possible to force the hand and cause these tumors to be sensitive to immunotherapy? The answer is yes. As demonstrated by the AtezoTRIBE study, presented at the European Congress of Medical Oncology.

The AtezoTRIBE study

The azetoTRIBE study is promoted by the GONO Foundation-Northwest Oncology Group and involved over 200 patients with metastatic colorectal cancer from 22 oncology centers throughout the country. “This clinical study is part of a very current line of research in recent years, focused on the development of therapeutic strategies that are able to extend the benefit of immunotherapy to the majority of colorectal cancers”, explains Chiara Cremolini, associate professor of medical oncology at the University of Pisa as well as president of the Foundation. The biological hypothesis is that a combination of drugs, folfoxiri and bevacizumab, currently possible standard treatment for this pathology, can make tumors “inflamed” with stability of microsatellites, and therefore ready to react to the action of a specific immunotherapeutic agent, atezolizumab . On the basis of this premise, the design of the study involved the random assignment of patients to two treatment arms: on the one hand the control treatment, folfoxiri and bevacizumab, and on the other the experimental treatment, i.e. the two drugs with the addition of atezolizumab.

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A new path is opening up

Well, the trio of molecules has proved capable of improving the expectations of patients with this neoplasm in the face of an easily manageable and clinically acceptable adverse effect profile. The results, which will not immediately change the therapeutic management of metastatic colon cancer, are an excellent starting point for continuing the further development of this combination, with the prospect of broadening the horizon of immunotherapy to a larger portion of patients with this neoplasm.

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