Multicenter Retrospective Study on Optimizing Combination Immunotherapy Strategies in MSS/MSI-L/pMMR Advanced Colorectal Cancer

NCT ID: NCT06849362

Last Updated: 2025-02-27

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ENROLLING_BY_INVITATION

Total Enrollment

200 participants

Study Classification

OBSERVATIONAL

Study Start Date

2019-12-01

Study Completion Date

2025-05-30

Brief Summary

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This multicenter retrospective study aims to evaluate and optimize combination immunotherapy strategies for patients with microsatellite stable (MSS), microsatellite instability-low (MSI-L), or mismatch repair-proficient (pMMR) advanced colorectal cancer (CRC). The study will analyze clinical outcomes, treatment responses, and prognostic factors in patients who received various immunotherapy regimens. Data from multiple institutions will be collected to identify potential predictive biomarkers and effective therapeutic combinations. The findings may provide critical insights for improving immunotherapy strategies in MSS/MSI-L/pMMR CRC patients.

Detailed Description

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This multicenter retrospective cohort study aims to evaluate the effectiveness of combination immunotherapy strategies in microsatellite stable (MSS), microsatellite instability-low (MSI-L), and mismatch repair-proficient (pMMR) advanced colorectal cancer (CRC) patients. Given the limited response of these CRC subtypes to immune checkpoint inhibitors (ICIs) alone, this study seeks to identify optimal combination regimens that can enhance therapeutic efficacy.

Study Objectives:

1. To assess clinical outcomes (e.g., overall survival, progression-free survival, objective response rate) in patients receiving different immunotherapy combinations.
2. To evaluate predictive biomarkers that may influence treatment response in MSS/MSI-L/pMMR CRC.
3. To compare the efficacy of various immunotherapy-based regimens, including ICIs combined with chemotherapy, targeted therapy, or anti-angiogenic agents like bevacizumab.

Methods:

* Data Source: Patient records from multiple institutions will be retrospectively analyzed.
* Patient Population: Individuals diagnosed with MSS/MSI-L/pMMR advanced CRC who have received at least one line of immunotherapy-based combination treatment.
* Data Collection: Demographics, tumor characteristics, treatment regimens, survival outcomes, and biomarker profiles.
* Statistical Analysis: Kaplan-Meier survival analysis, Cox proportional hazards model, and subgroup analyses based on biomarker expression.

Eligibility Criteria:

Approval was obtained from the institutional review boards of all four centers, adhering to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines and reported in accordance with the STROCSS 2024 criteria. Informed consent was not required.

* Inclusion Criteria:

* Patients with MSS metastatic colorectal cancer who underwent immunotherapy.
* Comprehensive collection of demographic and molecular characteristics.
* Patients were included irrespective of treatment context.
* Exclusion Criteria:

* Individuals lacking definitive pathological diagnosis.
* Patients without response evaluation data.
* Cases missing pertinent follow-up information.

Treatment Response Evaluation:

Treatment responses were evaluated radiographically according to the Response Evaluation Criteria in Solid Tumors (RECIST), version 1.1 guidelines.

Ethical Considerations:

Ethical approval was obtained from the institutional ethics committee of our hospital, ensuring compliance with ethical and regulatory standards for retrospective studies.

Expected Outcomes:

The study aims to identify effective treatment strategies for MSS/MSI-L/pMMR CRC patients, provide real-world evidence on the role of combination immunotherapy, and explore potential predictive biomarkers to improve patient selection for immunotherapy-based approaches.

This research will contribute to optimizing treatment strategies for immunotherapy-resistant CRC subtypes and guide future clinical trials.

Conditions

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Metastatic Colorectal Cancer (CRC) MSS Metastatic Colorectal Cancer Immunotherapy

Study Design

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Observational Model Type

COHORT

Study Time Perspective

RETROSPECTIVE

Study Groups

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Immunotherapy + Bevacizumab Group

Immunotherapy + Bevacizumab Group

Bevacizumab

Intervention Type DRUG

Bevacizumab is an anti-vascular endothelial growth factor (VEGF) monoclonal antibody used in combination with chemotherapy or immunotherapy for the treatment of metastatic colorectal cancer (CRC). In this study, bevacizumab is administered as part of combination therapy in certain patient groups to assess its impact on treatment efficacy in MSS/MSI-L/pMMR advanced colorectal cancer.

Patients receiving bevacizumab will be evaluated for treatment response, survival outcomes, and potential biomarkers predictive of therapeutic efficacy. The study will compare the clinical benefits of immunotherapy alone, immunotherapy + bevacizumab, and immunotherapy + chemotherapy + bevacizumab to determine the optimal treatment strategy.

The dose and administration schedule of bevacizumab will follow standard clinical guidelines as per institutional protocols.

Immunotherapy only Group

Immunotherapy only

No interventions assigned to this group

Immunotherapy + Chemotherapy + Bevacizumab Group

Immunotherapy + Chemotherapy + Bevacizumab

Bevacizumab

Intervention Type DRUG

Bevacizumab is an anti-vascular endothelial growth factor (VEGF) monoclonal antibody used in combination with chemotherapy or immunotherapy for the treatment of metastatic colorectal cancer (CRC). In this study, bevacizumab is administered as part of combination therapy in certain patient groups to assess its impact on treatment efficacy in MSS/MSI-L/pMMR advanced colorectal cancer.

Patients receiving bevacizumab will be evaluated for treatment response, survival outcomes, and potential biomarkers predictive of therapeutic efficacy. The study will compare the clinical benefits of immunotherapy alone, immunotherapy + bevacizumab, and immunotherapy + chemotherapy + bevacizumab to determine the optimal treatment strategy.

The dose and administration schedule of bevacizumab will follow standard clinical guidelines as per institutional protocols.

Chemotherapy only Group

Chemotherapy only

No interventions assigned to this group

Interventions

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Bevacizumab

Bevacizumab is an anti-vascular endothelial growth factor (VEGF) monoclonal antibody used in combination with chemotherapy or immunotherapy for the treatment of metastatic colorectal cancer (CRC). In this study, bevacizumab is administered as part of combination therapy in certain patient groups to assess its impact on treatment efficacy in MSS/MSI-L/pMMR advanced colorectal cancer.

Patients receiving bevacizumab will be evaluated for treatment response, survival outcomes, and potential biomarkers predictive of therapeutic efficacy. The study will compare the clinical benefits of immunotherapy alone, immunotherapy + bevacizumab, and immunotherapy + chemotherapy + bevacizumab to determine the optimal treatment strategy.

The dose and administration schedule of bevacizumab will follow standard clinical guidelines as per institutional protocols.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

\-
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Yue Gou

OTHER

Sponsor Role lead

Responsible Party

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Yue Gou

MD

Responsibility Role SPONSOR_INVESTIGATOR

Locations

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Xiangya hospital, CSU

Changsha, Hunan, China

Site Status

Countries

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China

Other Identifiers

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20240306-MSS-Gou

Identifier Type: -

Identifier Source: org_study_id

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