JAMA Oncol: PD-L1 and CTLA-4 double inhibition may improve survival in patients with advanced colon cancer

In addition to patients with high microsatellite instability (MSI-H), PD-L1 monoantigen was not effective in patients with advanced refractory colorectal cancer (CRC), and recently researchers examined the effects of the dual inhibition of metastatic CRC patients with procedural death ligand 1 (PD-L1) and cytotoxic T lymphocyte-related protein 4 (CTLA-4)studies conducted in Canada, with the participation of histologically confirmed patients with colon or rectal adenocarcinoma, who previously received all available standard systemic treatments such as fluoroquine, othalisheet, ilibution, bevastan, citopyriform and pani mono, with patients randomly taking 75 mg tremeliumab every 28 days for 1500 mg or 28 daysThe main endpoints of the study were total survival (OS), with baseline microsatellite instability (MSI) and tumor mutation load (TMB) assessment180 patients participated in the study, of whom 121 were men, the median age was 65 years old, and 179 patients were treatedThe median follow-up was 15.2 months, with the median OS in the Durvalumab-Tremelimumab group at 6.6 months and the BSC at 4.1 months (risk ratio: 0.72)No progression was 1.8 months and 1.9 months (HR: 1.01), respectivelyIn immunotherapy groups, the incidence of adverse events at level 3 or 4 was higher (64% vs20%)In patients with microsatellite stabilization (MSS), Durvalumab-Tremelimumab significantly improved patient OS (HR:0.66)Plasma TMB has the largest OS benefit for MSS patients with 28 variants/megabase or more (HR: 0.34)studies suggest that for patients with advanced refractory colorectal cancer, procedural death ligand 1 and cytotoxic T lymphocyte-related protein 4 dual immune checkpoint inhibitor or can improve patient survival