摘要
1 BACKGROUND With the rapid development of immune checkpoint inhibitors(ICIs)over the past decades,they have become a major area of interest in the treatment of colorectal cancer(CRC)[1,2].There are evidence pointing that programmed cell death protein-1(PD-1)blockade,alone or in combination with anti-cytotoxic T-lymphocyte-associated protein 4(anti-CTLA4)therapy,achieved durable responses in patients with mismatch repair-deficient(dMMR)or microsatellite instability-high(MSI-H)metastatic CRC(mCRC)[3–6].However,the optimal diagnostic method for detecting dMMR/MSI-H disease as well as the optimal anti-PD-1-based treatment modality still remains controversial in this patient subset.In addition,for the majority of mCRC cases that are mismatch repair-proficient(pMMR)or microsatellite stable(MSS),the clinical benefits from these agents are generally minimal[3,7],driving extensive research efforts to develop effective combination therapies in this disease subset.Moreover,investigations of anti-PD-1-based treatments have also been initiated in the nonmetastatic settings of CRC,with some encouraging preliminary evidence[8].Medical oncologists and surgeons from the Committee of Colorectal Cancer of the Chinese Society of Clinical Oncology had a panel discussion on immunotherapy for patients with colorectal cancer during a seminar on June 16,2020,in Guangzhou,China.Herein,the expert opinions have been summarized along with relevant clinical evidence(Table 1)to guide real-world treatment decision-making regarding the use of ICIs in patients with CRC.
