Howard S. Hochster, MD
The standard of care in the second line for patients with mismatch repair–deficient (dMMR) metastatic colorectal cancer (mCRC) has shifted to favor therapy utilizing immunotherapeutic agents, according to Howard Hochster, MD.
Table. (Click to Enlarge)
In the 3-arm COMMIT trial (NCT02997228), investigators are comparing atezolizumab alone versus a modified FOLFOX regimen (folinic acid, fluorouracil, and oxaliplatin; mFOLFOX6) plus bevacizumab (Avastin) with or without atezolizumab for patients with MSI-H mCRC in the frontline setting. Investigators in the ATOMIC trial (NCT02912559) will compare mFOLFOX plus 25 cycles of atezolizumab versus mFOLFOX alone for patients with stage III dMMR CRC in the adjuvant setting.
In the POLEM trial (NCT03827044), patients who have undergone radical surgical resection for stage III dMMR or POLE exonuclease domain–mutant colon cancer will be assigned to chemotherapy with CAPOX (capecitabine and oxaliplatin) for 12 weeks, capecitabine for 24 weeks, or chemotherapy followed by avelumab for 24 weeks.
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