Evidence map›Paper›PMID 42588653›Full record

ReviewCancers2026

Neoadjuvant PD-1-Based Immunotherapy in Localized dMMR/MSI-H Colorectal Cancer: A Systematic Review and Arm-Based Meta-Analysis.

Mohammed M Alruwaili, Yehia Nabil, Yousef Alanazi, Helal G Alanazi, Abdulrahman A Alahmari, Emad Alqassim, Baraah Abu Alsel, Manal S Fawzy

Abstract readReview
In one paragraph

Review in Cancers, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Mohammed M AlruwailiDepartment of Medical Laboratory Technology, College of Applied Medical Sciences, Northern Border University, Arar 91431, Saudi Arabia.ORCID 0000-0003-2811-4387
Yehia NabilFaculty of Medicine, Zagazig University, Zagazig 44519, Egypt.ORCID 0000-0002-1349-2978
Yousef AlanaziDepartment of Medical Laboratory Technology, College of Applied Medical Sciences, Northern Border University, Arar 91431, Saudi Arabia.
Helal G AlanaziDepartment of Medical Laboratory, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia.ORCID 0009-0004-3843-1137
Abdulrahman A AlahmariDepartment of Medical Laboratory, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia.ORCID 0000-0002-7211-3739
Emad AlqassimDepartment of Anatomic Pathology, Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia.ORCID 0009-0004-7070-1993
Baraah Abu AlselMedical Sciences & Preparatory Year Department, North Private College of Nursing, Arar 73244, Saudi Arabia.
Manal S FawzyCenter for Health Research, Northern Border University, Arar 91431, Saudi Arabia.ORCID 0000-0003-1252-8403

Funding

Northern Border University NBU-FFR-2026-2112-0
6 · The paper itself

Abstract

BACKGROUND/

objectivesDeficient mismatch repair (dMMR) and microsatellite instability-high (MSI-H) colorectal cancer (CRC) are highly sensitive to immune checkpoint blockade. We evaluated the efficacy, safety, and clinical maturity of neoadjuvant PD-1-based immunotherapy in localized disease.

methodsThis PRISMA-compliant systematic review included prospective studies of neoadjuvant PD-1-based therapy in localized dMMR/MSI-H CRC. Proportions were pooled on the logit scale using inverse-variance random-effects models with the Paule-Mandel estimator. Pathologic complete response (pCR) was the primary outcome; major pathologic response (MPR), immune-related adverse events (irAEs), surgery, clinical complete response (cCR), organ preservation, and long-term outcomes were secondary outcomes.

resultsFive prospective studies were included. Four studies, comprising 305 treated patients and 292 pathologically evaluable patients, contributed five treatment arms to the quantitative synthesis. The pooled pCR proportion was 0.65 (95% CI, 0.54-0.74), and the pooled MPR proportion was 0.89 (95% CI, 0.79-0.94). Exploratory subgroup analyses suggested higher response proportions with combination regimens, but clinical and methodological differences confounded these predominantly indirect comparisons. Any-grade irAEs occurred in 0.54 (95% CI, 0.36-0.71), whereas grade ≥3 irAEs occurred in 0.06 (95% CI, 0.04-0.10). The pooled surgery proportion was 0.96 (95% CI, 0.86-0.99), although this outcome largely reflected protocol-mandated surgery. cCR and organ preservation were promising in selected rectal-cancer cohorts. Survival and recurrence data were immature and unsuitable for quantitative pooling.

conclusionsNeoadjuvant PD-1-based immunotherapy is a highly promising investigational strategy for localized dMMR/MSI-H CRC. Nevertheless, predominantly early-phase evidence, indirect comparisons, heterogeneous endpoints, and limited follow-up preclude definitive conclusions regarding routine clinical adoption.

Indexed as

colorectal cancerdMMRimmune checkpoint blockademajor pathologic responsemeta-analysisMSI-Hneoadjuvant immunotherapyorgan preservationpathologic complete responsePD-1 inhibitors

Identifiers

PMID42588653
PMCPMC13464875

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.