Case Report: A long-term response of immunotherapy combined with anti-angiogenesis therapy in a patient with dMMR metastatic colorectal cancer after ICI failure

BackgroundImmune checkpoint inhibitors (ICIs) have demonstrated significant efficacy in patients with metastatic colorectal cancer (mCRC) characterized by high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR). However, most patients experience intrinsic or acquired resistance....

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Main Authors: Qianwen Huang, Xiaoling Zheng, Wenshen Xu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2025.1553380/full
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author Qianwen Huang
Xiaoling Zheng
Wenshen Xu
author_facet Qianwen Huang
Xiaoling Zheng
Wenshen Xu
author_sort Qianwen Huang
collection DOAJ
description BackgroundImmune checkpoint inhibitors (ICIs) have demonstrated significant efficacy in patients with metastatic colorectal cancer (mCRC) characterized by high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR). However, most patients experience intrinsic or acquired resistance. The need for treatment for patients with MSI-H/dMMR mCRC remains unmet. Here, we report the case of a patient with dMMR mCRC who achieved a durable therapeutic benefit from the combination of ICI and angiogenesis inhibitor after ICI failure.Case presentationA 40-year-old Chinese woman diagnosed with cT4N2M1b mCRC characterized by dMMR attributed to MLH-1 and PMS-2 deficiency, along with KRAS mutation. Primarily, the patient was treated with a combination of Chinese medicine and XELOX and underwent disease progression. Due to dMMR status, this patient then received single-agent camrelizumab. Unfortunately, disease progression was observed after two cycles of treatment. Subsequently, she received camrelizumab combined with bevacizumab. After treatment, the patient achieved a complete response, and the disease was sustainably controlled with a progression-free survival (PFS) of 3 years and counting.ConclusionsThis report demonstrates that the combination of ICI and anti-angiogenesis therapy can induce a powerful and durable antitumor response in patients with ICI-resistant MSI-H/dMMR mCRC, which is worthy of further research.
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spelling doaj-art-ff8d60563d66485ea732145eeedd56572025-08-20T02:16:44ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-04-011510.3389/fonc.2025.15533801553380Case Report: A long-term response of immunotherapy combined with anti-angiogenesis therapy in a patient with dMMR metastatic colorectal cancer after ICI failureQianwen Huang0Xiaoling Zheng1Wenshen Xu2Department of Medical Oncology, Boluo County People’s Hospital, Huizhou, ChinaDepartment of Pharmacy, Boluo County People’s Hospital, Huizhou, ChinaDepartment of Medical Oncology, Boluo County People’s Hospital, Huizhou, ChinaBackgroundImmune checkpoint inhibitors (ICIs) have demonstrated significant efficacy in patients with metastatic colorectal cancer (mCRC) characterized by high microsatellite instability (MSI-H) or deficient mismatch repair (dMMR). However, most patients experience intrinsic or acquired resistance. The need for treatment for patients with MSI-H/dMMR mCRC remains unmet. Here, we report the case of a patient with dMMR mCRC who achieved a durable therapeutic benefit from the combination of ICI and angiogenesis inhibitor after ICI failure.Case presentationA 40-year-old Chinese woman diagnosed with cT4N2M1b mCRC characterized by dMMR attributed to MLH-1 and PMS-2 deficiency, along with KRAS mutation. Primarily, the patient was treated with a combination of Chinese medicine and XELOX and underwent disease progression. Due to dMMR status, this patient then received single-agent camrelizumab. Unfortunately, disease progression was observed after two cycles of treatment. Subsequently, she received camrelizumab combined with bevacizumab. After treatment, the patient achieved a complete response, and the disease was sustainably controlled with a progression-free survival (PFS) of 3 years and counting.ConclusionsThis report demonstrates that the combination of ICI and anti-angiogenesis therapy can induce a powerful and durable antitumor response in patients with ICI-resistant MSI-H/dMMR mCRC, which is worthy of further research.https://www.frontiersin.org/articles/10.3389/fonc.2025.1553380/fullmetastatic colorectal cancerhigh microsatellite instabilitydeficient mismatch repairimmune checkpoint inhibitorsanti-angiogenesis therapy
spellingShingle Qianwen Huang
Xiaoling Zheng
Wenshen Xu
Case Report: A long-term response of immunotherapy combined with anti-angiogenesis therapy in a patient with dMMR metastatic colorectal cancer after ICI failure
Frontiers in Oncology
metastatic colorectal cancer
high microsatellite instability
deficient mismatch repair
immune checkpoint inhibitors
anti-angiogenesis therapy
title Case Report: A long-term response of immunotherapy combined with anti-angiogenesis therapy in a patient with dMMR metastatic colorectal cancer after ICI failure
title_full Case Report: A long-term response of immunotherapy combined with anti-angiogenesis therapy in a patient with dMMR metastatic colorectal cancer after ICI failure
title_fullStr Case Report: A long-term response of immunotherapy combined with anti-angiogenesis therapy in a patient with dMMR metastatic colorectal cancer after ICI failure
title_full_unstemmed Case Report: A long-term response of immunotherapy combined with anti-angiogenesis therapy in a patient with dMMR metastatic colorectal cancer after ICI failure
title_short Case Report: A long-term response of immunotherapy combined with anti-angiogenesis therapy in a patient with dMMR metastatic colorectal cancer after ICI failure
title_sort case report a long term response of immunotherapy combined with anti angiogenesis therapy in a patient with dmmr metastatic colorectal cancer after ici failure
topic metastatic colorectal cancer
high microsatellite instability
deficient mismatch repair
immune checkpoint inhibitors
anti-angiogenesis therapy
url https://www.frontiersin.org/articles/10.3389/fonc.2025.1553380/full
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AT xiaolingzheng casereportalongtermresponseofimmunotherapycombinedwithantiangiogenesistherapyinapatientwithdmmrmetastaticcolorectalcanceraftericifailure
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