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Colorectal cancer is one of the most common malignancies of the digestive tract worldwide and represents a major subtype of colorectal carcinoma. Early-stage patients can often achieve curative outcomes through surgery; however, treatment of locally advanced cases remains challenging due to high recurrence risk and therapeutic difficulty, making it a persistent clinical concern. Recently, the oncology team at Jinshazhou Hospital of Guangzhou University of Chinese Medicine successfully implemented a preoperative "dual immunotherapy regimen" for colorectal cancer, providing a novel treatment option for patients with locally advanced MSI-H/dMMR colorectal tumors.
World's First Preoperative Dual Immunotherapy Regimen Introduced, Paving a New Path to Curative Treatment
The recently applied "dual immunotherapy regimen" centers on a combination of Tyvyt and Daboxin. This regimen represents the first and only globally approved dual immunotherapy approach for MSI-H/dMMR colorectal cancer in the neoadjuvant setting. Clinical data show that with just two cycles of this "Shuxin combination" neoadjuvant therapy, the pathological complete response (pCR) rate can reach 82%.
"This is the first application of a preoperative dual immunotherapy regimen for colorectal cancer in China. After verification through Phase III clinical trials, the efficacy is remarkable," stated Liu Wenwei, President of Jinshazhou Hospital of Guangzhou University of Chinese Medicine. Post-treatment pathological examination revealed that tumor cells had completely disappeared in 82% of patients, indicating that the tumor was effectively controlled before surgery. This not only greatly improves the likelihood of a curative surgical outcome but also reduces the risk of postoperative recurrence.
Synergistic Action of Dual Immunotherapy Mechanisms
For general understanding, the principle behind the "dual immunotherapy regimen" is straightforward: two complementary immune therapies work together --- one to release tumors' inhibition of immune cells, and the other to awaken and activate additional immune cells --- thereby enhancing the immune system's ability to recognize and eliminate cancer cells.
From a mechanistic perspective, the PD-1 inhibitor and the CTLA-4 inhibitor in the regimen both act on the immune system but with different focuses. The PD-1 inhibitor primarily removes the suppression on immune cells, restoring their functional activity, while the CTLA-4 inhibitor not only assists in lifting tumor-induced suppression but also eliminates regulatory T cells that could interfere with immune function. Used together, these agents create a mutually reinforcing synergistic effect, producing a more pronounced anti-tumor response.
Indigenously Developed Drugs Enhance Treatment Accessibility
Notably, the core drugs in this regimen --- Tyvyt and Daboxin --- are original, locally developed drugs from China. Their use highlights the progress of domestically innovated pharmaceuticals in the field of tumor immunotherapy and provides patients with greater access to advanced treatment options.
At the same time, some patients expressed concern that combining the two drugs might lead to overlapping side effects. Liu Ying, Director of the Department of Integrated Tumor Therapy at Jinshazhou Hospital of Guangzhou University of Chinese Medicine, clarified: "The side effect profiles of the two drugs differ. CTLA-4 inhibitors may carry a slightly higher risk of immune-related myocarditis in some patients, while PD-1 inhibitors are more likely to cause immune-related dermatitis or rashes. However, their combined use does not result in cumulative side effects, and the safety of the regimen is well supported."
A New Step in Precision Therapy Benefits More Cancer Patients
The successful application of the world's first preoperative "double immunotherapy" regimen for colon cancer at Jinshazhou Hospital of Guangzhou University of Chinese Medicine not only provides a new treatment option for patients with locally advanced colon cancer, but also marks an important step forward for China in the field of precision colon cancer therapy. Director Liu Wenwei stated that the hospital will continue to accumulate clinical experience and optimize treatment protocols, ensuring that this advanced technology better serves a broader population of cancer patients and contributes to raising the overall standard of cancer care in China.
