ArticleAnnals of surgical oncology2025
Neoadjuvant Immunotherapy Followed by Surgery Compared with Upfront Surgery Alone in Operable Colon Cancer with Deficient Mismatch Repair: Modeling Oncological Outcomes and Numbers Needed to Treat.
Article in Annals of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT01762813 (Prospective, Population-based Cohort Collection of Blood Samples and Tumor Tissue From Patients Operated on for Primary or Metastatic Colorectal Cancer), which is not on this map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Prospective, Population-based Cohort Collection of Blood Samples and Tumor Tissue From Patients Operated on for Primary or Metastatic Colorectal Cancer
Who cites it
2 citing papers in PubMed.
- Toripalimab, bevacizumab, and irinotecan in dMMR/MSI locally advanced colorectal cancer: First-stage results from a phase 1b/2 trial.Cell reports. Medicine · 2025Trial
- Exercise therapy in cancer prevention and treatment.Nature reviews. Clinical oncology · 2026Review
Corrections and comments
- Erratum issued
Authors and funding
8 authors.
Funding
Abstract
backgroundTrials on neoadjuvant immunotherapy in operable colon cancer with deficient mismatch repair (dMMR) reported high pathological response rates in the surgical specimen, but long-term survival is not known. Neoadjuvant immunotherapy as a stand-alone therapy without subsequent radical surgery is currently not investigated in colon cancer.
objectiveThe aim of this study was to model outcomes between trial data and real-world patients after surgery.
methodsWe conducted a comparative modeling study between prospective trial data (NICHE-1) and a prospective, population-derived, translational cohort study (ACROBATICC) of patients with operable colon cancer and microsatellite instability (MSI) status. Comparison was performed across immune-cell infiltrates, stages, MSI, and patient demographics for adverse events, reported oncological outcomes, and modeling numbers needed to treat (NNT) to prevent recurrence.
resultsPatient characteristics between the dMMR tumors in the NICHE-1 (n = 21) and ACROBATICC (n = 43) cohorts differed, with older patients and fewer hereditary dMMRs in the 'real-life' ACROBATICC cohort. Higher expression of CD8+ in dMMR tumors compared with proficient mismatch repair (pMMR) tumors was statistically significant across both cohorts. At long-term follow-up, 2/43 patients with dMMR had died from recurrent colon cancer in the ACROBATICC cohort. Assuming a curative effect of neoadjuvant immunotherapy in addition to surgery in dMMR tumors, the NNT would be >20 patients for any additional survivor.
conclusionIn unselected patients with colon cancer having dMMR, recurrence risk is very low after surgery. Assuming a curative effect of neoadjuvant immunotherapy beyond surgery alone, the NNT would be at least 20 patients to prevent one cancer death over surgery alone.
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