Immunotherapy for Colorectal Cancer

When Can Immunotherapy Be Used to Treat Colorectal Cancer?

The immunotherapy drug Keytruda (pembrolizumab) has been shown to be effective in treating a type of colorectal cancer called deficient mismatch repair (dMMR) or microsatellite instability high (MSI-H) colorectal cancer.

What Is dMMR/MSI-H Colorectal Cancer?

Colorectal cancer is the third most common cancer in the world, with 150,000 new cases diagnosed in the U.S. every year. Roughly 80 percent of people are diagnosed at an early stage, before the cancer has spread to other parts of the body. Of those, approximately 15 to 20 percent are classified as dMMR colon cancer and 2 to 3 percent are classified as dMMR rectal cancer.

The body replaces the cells that line the colon every five to seven days with new cells. The new cells are produced so rapidly that some cells are defective. Normally, the immune system identifies and destroys these defective or mismatched cells.

Colorectal cells with the dMMR genomic defect are unable to repair the mutations that occur during cell replication. When a dMMR cell grows into a cancer cell, it produces an immune tolerance, meaning it remains hidden from the immune system. As a result, the defective cells are free to replicate and form tumors.

What Is Keytruda?

Keytruda is administered as an infusion therapy, delivered directly into the bloodstream by a needle through a vein. The infusion takes about 45 minutes and can be done at your doctor’s office or an infusion clinic.

Some dMMR/MSI-H colorectal cancer patients achieve complete remission with Keytruda immunotherapy, with no evidence of disease.

Who Is Eligible For Keytruda Therapy?

Keytruda is FDA-approved for use in the treatment of dMMR/MSI-H colorectal cancer that is unresectable (cannot be removed completely with surgery) or metastatic (has spread to other parts of the body).

For many colorectal cancer patients, treatment involves some combination of surgery, chemotherapy and radiation, all of which cause side effects. Surgery, in particular, can be challenging for older patients, especially those with other health issues. Keytruda offers an excellent treatment alternative to achieve remission. Keytruda is well tolerated in over 90 percent of the patients who take it, including most elderly patients.

Does Keytruda Have Side Effects?

Keytruda can cause your immune system to attack healthy organs and tissues in the body, affecting the way they work and causing side effects. Your doctor will discuss potential side effects and ways to manage them with you.

Why Choose UH for Immunotherapy?

Ranked one of the best cancer hospitals in the country by U.S. News & World Report for over 20 years, University Hospitals Seidman Cancer Center is dedicated exclusively to the diagnosis and treatment of cancer and blood disorders. Among our innovation efforts, we are at the forefront of expanding the use of immunotherapy in the treatment of colorectal and other types of cancer.

UH Seidman Cancer Center has launched a national database called DREAM-GI to track dMMR/MSI-H colorectal cancer patients treated with Keytruda at UH Seidman Cancer Center and other cancer centers throughout the U.S. The purpose of the database is to track patient data over five years to evaluate the long-term results of the treatment. In doing so, the database will help inform future treatment guidelines, potentially positioning Keytruda as a first-line treatment for dMMR/MSI-H colorectal cancer. As a result, it could be used before surgery, chemotherapy and radiation therapy in certain patients, perhaps eliminating the need for conventional treatments and the related side effects.

Which Doctors Treat Colorectal Cancer Patients With Immunotherapy?

The following doctors at UH Seidman Cancer Center provide immunotherapy to eligible colorectal cancer patients: