Colorectal cancer (CRC) is a leading cause of cancer-related death worldwide. Despite advancements in screening and treatment, the 5-year survival rate of metastatic CRC patients remains low. Immunotherapy has emerged as a promising approach to treat CRC by harnessing the immune system to target cancer cells, while sparing healthy tissues. This review discusses current immunotherapeutic strategies for CRC, including immune checkpoint blockade (ICB), adoptive cell therapy (ACT), monoclonal antibodies (mAbs), oncolytic viruses, cancer vaccines, and immunomodulatory drugs. ICB therapies, such as anti-PD-1/PD-L1 and anti-CTLA-4, have shown efficacy in microsatellite instability-high (MSI-H) CRC patients, but remain limited in microsatellite stable cases. ACT, including tumor-infiltrating lymphocyte and CAR-NK cell therapies, has demonstrated potential in clinical studies. mAbs, such as cetuximab and bevacizumab, continue to be the mainstay of treatment, while bispecific antibodies (bsAbs) show promise in combination with anti-PD-1 therapies. Oncolytic viruses and cancer vaccines have shown variable results in CRC. Interleukins (ILs) and interferons (IFNs) play a role in modulating the immune response, with IL-2, IL-12, and IFN-γ exhibiting anti-tumor effects. Immunomodulatory drugs, such as thalidomide and maraviroc, augment anti-tumor effects by modifying immunological function. Despite progress, challenges remain in optimizing and expanding the use of immunotherapy for all subgroups of patients with CRC. Future directions include combination treatments, tumor microenvironment modification, personalized tumor vaccines, and development of predictive biomarkers to guide patient selection and treatment planning.
Kaunain et al. (Wed,) studied this question.
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