Neoadjuvant immunotherapy for dMMR/MSI-H locally advanced rectal cancer patients: demystifying the 100% clinical complete response paradigm

Six months of treatment with dostarlimab followed by nonoperative management in case of clinical complete response (cCR) is the new standard-of-care for patients with microsatellite instability-high (MSI-H)/mismatch repair deficient (dMMR) locally advanced rectal cancer (LARC). The most recent update of the seminal phase II trial by Cercek et al. shows a cCR rate of 100% that allowed sparing chemoradiation and surgery to all included patients. Here, we present three clinical cases of patients with dMMR and MSI-H LARC treated with neoadjuvant dostarlimab at three Italian institutions with radiological evidence of disease progression while on treatment and discuss potential similarities among them to understand when and how this apparently rare event may occur.

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Publication Details

Journal
The Oncologist
Published
2025-11-28
DOI
https://doi.org/10.1093/oncolo/oyaf394
Primary Topic
Genetic factors in colorectal cancer
Type
article
Field-Weighted Citation Impact
0.00

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article

Neoadjuvant immunotherapy for dMMR/MSI-H locally advanced rectal cancer patients: demystifying the 100% clinical complete response paradigm

Clara Ugolini, Annalice Gandini, Federica Marmorino, Federica Morano et al.
The Oncologist
Genetic factors in colorectal cancer
article

Neoadjuvant immunotherapy for dMMR/MSI-H locally advanced rectal cancer patients: demystifying the 100% clinical complete response paradigm

Clara Ugolini, Annalice Gandini, Federica Marmorino, Federica Morano, Chiara Cremolini, Maria Anna Canciello, Pierre Laurent‐Puig, Piercarlo Rossi, Erika Martinelli
article en

Abstract

Six months of treatment with dostarlimab followed by nonoperative management in case of clinical complete response (cCR) is the new standard-of-care for patients with microsatellite instability-high (MSI-H)/mismatch repair deficient (dMMR) locally advanced rectal cancer (LARC). The most recent update of the seminal phase II trial by Cercek et al. shows a cCR rate of 100% that allowed sparing chemoradiation and surgery to all included patients. Here, we present three clinical cases of patients with dMMR and MSI-H LARC treated with neoadjuvant dostarlimab at three Italian institutions with radiological evidence of disease progression while on treatment and discuss potential similarities among them to understand when and how this apparently rare event may occur.

The OncologistVol. 30(12)
University of Pisa (IT), Inserm (FR), Université Paris Cité (FR), Sorbonne Université (FR), Sorbonne Paris Cité (FR), Centre de Recherche des Cordeliers (FR), Hôpital Européen (FR), University of Campania "Luigi Vanvitelli" (IT), Azienda Ospedaliera Universitaria Università degli Studi della Campania Luigi Vanvitelli (IT), Ospedale Policlinico San Martino (IT), Fondazione IRCCS Istituto Nazionale dei Tumori (IT), Azienda Ospedaliera Universitaria Pisana (IT)
European Commission, Università di Pisa
Openalex Percentile: Top 48%
Genetic factors in colorectal cancer
DOIOpen Access PDFOpenAlex
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