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Topics:
Gastrointestinal Cancers • Medical Oncology • Colorectal Cancer • Journal Club ft. Lancet publication
How do CheckMate 8HW results impact your sequencing of available therapies in dMMR/MSI-H metastatic colorectal cancer?
Will you now uniformly start with nivo/ipi > chemotherapy? If so, would you ever reintroduce another checkpoint monotherapy down the line? Or do you use checkpoint monotherapy and escalate to nivo/ipi at a subsequent line of treatment?
Answer from: Medical Oncologist at Community Practice
The results of CheckMate 8HW further reinforce the use of immunotherapy over chemotherapy for dMMR/MSI-H metastatic colorectal cancer. In 2025, in my practice, assuming a patient has no contraindications to immunotherapy, I see no role for chemotherapy in 1st line metastatic colorectal cancer that i...
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Answer from: Medical Oncologist at Academic Institution
I am routinely assessing all stage IV colorectal cancer patients with dMMR/MSI-high disease for ipi/nivo, as I believe that is now the standard of care. However, when there is toxicity, I have a low threshold to drop the ipilimumab and continue with checkpoint inhibition if appropriate. I am also re...
Answer from: Medical Oncologist at Community Practice
In line with CheckMate 8HW, other critical studies, and NCCN guidelines, I treat all metastatic MSI-H colorectal patients with immune checkpoint inhibitors in first line, unless there is a clear contraindication. In CheckMate 8HW, we see significant improvement in both PFS and OS, as well as lower r...