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April 19, 2026Cancer Research

Abstract CT170: Neoadjuvant pembrolizumab stratified by tumor mutation burden in high-risk stage II-III dMMR/MSI colorectal cancer (NEOPRISM-CRC): Perioperative ultrasensitive ctDNA monitoring and tumor-infiltrating TCR repertoire for treatment response prediction

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Authors

YJYanrong JiangUniversity College LondonAMAnna-Maria MilitelloEast London NHS Foundation TrustCACharles W. Abbott

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Implication

Phase 2 trial examines ctDNA monitoring and TCR repertoire for predicting treatment response in high-risk patients.

Key Points

  • The aim is to evaluate how ctDNA dynamics and TCR repertoire can predict treatment response to neoadjuvant pembrolizumab in high-risk colorectal cancer.
  • 32 patients received neoadjuvant pembrolizumab before surgery.
  • ctDNA profiling tracked patient-specific variants across multiple timepoints.
  • TCR sequencing conducted on pre-treatment tumor biopsies to analyze clonality.
  • Comparisons made between responders and non-responders based on TCR metrics.
  • Bayesian modeling integrated ctDNA and TCR data for response prediction.
  • 74% of TMB-H patients had evaluable ctDNA and tissue samples.
  • Pre-surgery ctDNA clearance correlated with a high pCR rate of 92.9%.
  • Patients clearing ctDNA before treatment cycles achieved a pCR rate of 100%.
  • All patients maintained undetectable ctDNA levels for 24 months post-surgery.
  • Larger TCR clonotypes in responders were significantly associated with pathological response.

Cite This Study

Jiang et al. (2026) studied this question.

synapsesocial.com/papers/69e473bd010ef96374d8f75chttps://doi.org/10.1158/1538-7445.am2026-ct170
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1NEOPRISM-CRC: Neoadjuvant pembrolizumab stratified to tumour mutation burden for high risk stage 2 or stage 3 deficient-MMR/MSI-high colorectal cancer.2024 · 37 citations
  2. 2Circulating tumor DNA as a predictive biomarker for pathologic response after treatment with neoadjuvant immunotherapy for localized dMMR/MSI-H colorectal cancer.2024 · 3 citations
  3. 3Abstract CT171: Early findings from MONITOR-Breast: ctDNA dynamics during neoadjuvant therapy using an ultrasensitive MRD assay2026 · 1 citations
  4. 4Abstract PS1-13-11: Personalized Whole-Genome-Based ctDNA Dynamics During Neoadjuvant Therapy Across Breast Cancer Subtypes: Early Insights From MONITOR-Breast2026
  5. 5Dynamic circulating tumor DNA profiling for prediction of long-term clinical benefit in pMMR locally advanced rectal cancer receiving neoadjuvant chemoradiotherapy plus sintilimab.2026