Hereditary colorectal cancer: Immunotherapy approaches

Abstract

Advances in our understanding of the tumor-immune microenvironment have provided new therapeutic approaches to treat cancer. While first-line medical treatment for colorectal cancer typically involves chemotherapy and biological agents, the clinical efficacy of immune checkpoint inhibitors in microsatellite instability-high colorectal cancer has prompted renewed interest in immunotherapy as a treatment strategy for this tumor type. For patients with hereditary colorectal cancer syndromes characterized by exceptionally high somatic mutational loads, immunotherapy has specifically shown exceptional promise. In this chapter, we explore the rationale for immunotherapy in the treatment of colorectal cancer and focus on various immunotherapeutic strategies attempted thus far, including autologous, peptide, dendritic and viral vector-based vaccines, adoptive cell transfer, chimeric antigen receptor T-cell therapy, and immune checkpoint inhibitors. In addition, we discuss novel combination approaches and innovative techniques under investigation to create a more immune-responsive tumor environment for microsatellite stable colorectal cancer.