Judge, SJ, Ji, J, Liu, J, Kaur, M, Kim, E, Gong, J, Tam, KW, Kirane, AR, Gholami, S, Canter, RJ, Bold, RJ, Gangi, A, Fakih, M, Cho, M (April 2020) The Role of Palliative Surgery for Malignant Bowel Obstruction and Perforation in Advanced Microsatellite Instability-High Colorectal Carcinoma in the Era of Immunotherapy: Case Report. Frontiers in Oncology, 10. ISSN 2234-943X
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Abstract
The role of palliative surgery in the management of acute complications in patients with disseminated malignancy remains controversial given the complexity of assessing acute surgical risk and long-term oncologic outcome. With the emergence of checkpoint blockade immunotherapy, there appears to be an increasing role for historically palliative procedures as a bridge to systemic immunotherapy. This is especially evident in advanced microsatellite instability-high (MSI-H) colorectal cancer where malignant obstruction and fistula formation are more common and where immunotherapy with checkpoint blockade (anti-PD-1/PD-L1, anti-CTLA-4) has a high response rate with potential for favorable oncologic outcomes. We present a series of three patients with MSI-H metastatic colorectal cancer complicated by malignant bowel obstruction and fistula formation, who having progressed on standard chemotherapy, underwent palliative intervention as a bridge to immune checkpoint blockade with durable and clinically meaningful anti-cancer responses. These cases highlight the need to re-evaluate the role of historically palliative operations in the setting of disease progression for immunotherapy-responsive tumors.
| Item Type: | Paper |
|---|---|
| Subjects: | diseases & disorders > cancer diseases & disorders diseases & disorders > cancer > cancer types > colon cancer diseases & disorders > cancer > cancer types > colon cancer diseases & disorders > cancer > drugs and therapies diseases & disorders > cancer > drugs and therapies > Immunotherapy diseases & disorders > cancer > cancer types |
| CSHL Authors: | |
| Communities: | CSHL labs > Gholami Lab |
| SWORD Depositor: | CSHL Elements |
| Depositing User: | CSHL Elements |
| Date: | 21 April 2020 |
| Date Deposited: | 05 Oct 2023 17:45 |
| Last Modified: | 30 Jan 2024 21:09 |
| PMCID: | PMC7186327 |
| Related URLs: | |
| URI: | https://repository.cshl.edu/id/eprint/41136 |
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