ReviewCancers2026
Neoadjuvant PD-1-Based Immunotherapy in Localized dMMR/MSI-H Colorectal Cancer: A Systematic Review and Arm-Based Meta-Analysis.
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.
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.
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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.
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Who cites it
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Corrections and comments
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Authors and funding
8 authors.
Funding
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.
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