title: Immunotherapy for colorectal cancer: where are we heading?
abstract: In the last few years, significant advances in molecular biology have provided new therapeutic options for colorectal cancer (CRC). The development of new drugs that target the immune response to cancer cells seems very promising and has already been established for other tumor types. In particular, the use of immune checkpoint inhibitors seems to be an encouraging immunotherapeutic strategy. Areas covered: In this review, the authors provide an update of the current evidence related to this topic, though most immunotherapies are still in early-phase clinical trials for CRC. To understand the key role of immunotherapy in CRC, the authors discuss the delicate balance between immune-stimulating and immune-suppressive networks that occur in the tumor microenvironment. Expert opinion: Modulation of the immune system through checkpoint inhibition is an emerging approach in CRC therapy. Nevertheless, selection criteria that could enable the identification of patients who may benefit from these agents are necessary. Furthermore, potential prognostic and predictive immune biomarkers based on immune and molecular classifications have been proposed. As expected, additional studies are required to develop biomarkers, effective therapeutic strategies and novel combinations to overcome immune escape resistance and enhance effector response.
authors.affiliation: a Department of Oncology , University and General Hospital , Udine , Italy.
authors.forename: Debora
authors.initials: D
authors.lastname: Basile
authors.affiliation: a Department of Oncology , University and General Hospital , Udine , Italy.
authors.forename: Silvio Ken
authors.initials: SK
authors.lastname: Garattini
authors.affiliation: a Department of Oncology , University and General Hospital , Udine , Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Bonotto
authors.affiliation: a Department of Oncology , University and General Hospital , Udine , Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Ongaro
authors.affiliation: a Department of Oncology , University and General Hospital , Udine , Italy.
authors.forename: Mariaelena
authors.initials: M
authors.lastname: Casagrande
authors.affiliation: a Department of Oncology , University and General Hospital , Udine , Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Cattaneo
authors.affiliation: a Department of Oncology , University and General Hospital , Udine , Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Fanotto
authors.affiliation: a Department of Oncology , University and General Hospital , Udine , Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: De Carlo
authors.affiliation: c Medical Oncology 1, Department of Medical and Experimental Oncology , IOV - IRCCS , Padova , Italy.
authors.forename: Fotios
authors.initials: F
authors.lastname: Loupakis
authors.affiliation: b Medical Oncology B, Department of Dermatological Sciences, Radiology and Pathology , La Sapienza University , Rome , Italy.|c Medical Oncology 1, Department of Medical and Experimental Oncology , IOV - IRCCS , Padova , Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Urbano
authors.affiliation: d Department of Oncology , University Hospital , Parma , Italy.
authors.forename: Francesca V
authors.initials: FV
authors.lastname: Negri
authors.affiliation: a Department of Oncology , University and General Hospital , Udine , Italy.
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Pella
authors.affiliation: e Medical Oncology , Campus Biomedico University , Roma , Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Russano
authors.affiliation: f Medical Oncology Unit , National Cancer Institute IRCCS "Giovanni Paolo II" , Bari , Italy.
authors.forename: Oronzo
authors.initials: O
authors.lastname: Brunetti
authors.affiliation: g Medical Oncology , University Hospital and University of Cagliari , Cagliari , Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Scartozzi
authors.affiliation: e Medical Oncology , Campus Biomedico University , Roma , Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Santini
authors.affiliation: f Medical Oncology Unit , National Cancer Institute IRCCS "Giovanni Paolo II" , Bari , Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Silvestris
authors.affiliation: h Department of Medical Oncology , IRST IRCCS , Meldola , Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Casadei Gardini
authors.affiliation: g Medical Oncology , University Hospital and University of Cagliari , Cagliari , Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Puzzoni
authors.affiliation: i Department of Oncology , San Bortolo General Hospital , Vicenza , Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Calvetti
authors.affiliation: i Department of Oncology , San Bortolo General Hospital , Vicenza , Italy.
authors.forename: Nadia
authors.initials: N
authors.lastname: Cardarelli
authors.affiliation: a Department of Oncology , University and General Hospital , Udine , Italy.|i Department of Oncology , San Bortolo General Hospital , Vicenza , Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Aprile
mesh_terms: D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D060908:CTLA-4 Antigen / Q000276:immunology / Q000378:metabolism; D015179:Colorectal Neoplasms / Q000276:immunology / Q000473:pathology / Q000628:therapy*; D004359:Drug Therapy, Combination; D006801:Humans; D007167:Immunotherapy; D045164:Mesenchymal Stem Cell Transplantation; D059630:Mesenchymal Stem Cells / Q000166:cytology / Q000378:metabolism; D011379:Prognosis; D013601:T-Lymphocytes / Q000276:immunology / Q000378:metabolism; D059016:Tumor Microenvironment
chemical_list: D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents; D060908:CTLA-4 Antigen
keywords: Immunotherapy; MSI; PD-L1; atezolizumab; colorectal cancer; pembrolizumab