Immunotherapy Treatment for Advanced Colorectal Cancer
Immuno-oncology (or immunotherapy) and precision medicine are the newest developments in the treatment of advanced cancer. Immuno-oncology helps to restore the body’s immune system and improves outcomes when administered alone or in combination with chemotherapy.
Immunotherapy is class of treatments that take advantage of a person’s own immune system to help kill cancer cells.
- Bevacizumab (Avastin®): a monoclonal antibody that targets the VEGF/VEGFR pathway and inhibits tumor blood vessel growth; approved for subsets of patients with colorectal cancer in combination with chemotherapy
- Cetuximab (Erbitux): targets EGFR
- Encorafenib (Braftovi): attacks the abnormal BRAF protein directly
- Lonsurf (Trifluridine plus Tipiracil): trifluridine is a nucleoside metabolic inhibitor and tipiracil is a thymidine phosphorylase inhibitor
- Panitumumab (Vectibixx): targets EGFR
- Pembrolizumab (Keytruda®): a checkpoint inhibitor that targets the PD-1/PD-L1 pathway; approved for subsets of patients with advanced colorectal cancer that has PD-L1 expression, high microsatellite instability (MSI-H), DNA mismatch repair deficiency (dMMR), or high tumor mutational burden (TMB-H)
- Ramucirumab (Cyramza): targets the VEGF/VEGFR pathway and inhibits tumor blood vessel growth
- Regorafenib (Stivarga): targeted therapy known as a kinase inhibitor
- Yervoy IIpilimumab): Used in combination with nivolumab. Metastatic mismatch repair deficient (dMMR) and microsatellite instability-high (MSI-H) CRC
- Ziv-aflibercept (Zaltrap): targets the VEGF/VEGFR pathway and inhibits tumor blood vessel growth
The goal of immunotherapy is to help the immune system recognize and eliminate cancer cells by either activating the immune system directly, or by inhibiting mechanisms of suppression of the cancer.
In an attempt to improve the chance of cure, immunotherapies are being tested alone or in combination with chemotherapy in clinical trials.