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ASCO 2025 | Which patients with colorectal cancer will benefit the most from nivolumab?
Heinz-Josef Lenz, MD, FACP, University of Southern California, Los Angeles, CA, comments on the limitations of nivolumab in treating certain patients with microsatellite instability-high/mismatch repair-deficient (MSI-H/dMMR) metastatic colorectal cancer who have disease progression. Innate resistance is a significant challenge, affecting approximately 10-20% of patients, and combination treatment may be a promising approach to increase efficacy. Biomarker research is essential to understand who will respond to nivolumab alone versus in combination with other therapies. This interview took place during the 2025 American Society of Clinical Oncology (ASCO) Meeting in Chicago, IL.
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Transcript
Despite the incredible efficacy of Nivo, there are still some patients who have progression of disease, innate resistance. In Nivo, it’s about 10%, for Nivo it’s about almost 20%. We still don’t understand the mechanism of innate resistance because there is not an acquired resistance. So this needs to be looked at and a lot of biomarker research is looking into that...
Despite the incredible efficacy of Nivo, there are still some patients who have progression of disease, innate resistance. In Nivo, it’s about 10%, for Nivo it’s about almost 20%. We still don’t understand the mechanism of innate resistance because there is not an acquired resistance. So this needs to be looked at and a lot of biomarker research is looking into that. I also think that maybe combination treatment may be something very important to look into to further increase the efficacy. The efficacy is already amazing, but that would be very important. I think that understanding who will have a complete response, which is about 30% in both arms, would be also helpful because if we would have that technically, we would only need to treat with Nivo alone and not with a combination which shows a little bit higher side effects but not overall medically concerning. So I think the biomarker research for predictive outcome in order to decide and really personalize the treatment may be very important and for the resistance what potential combination may be even more effective.
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