Efficacy

Opdivo (Nivolumab) in Colorectal Cancer

Opdivo, also known as Nivolumab, is a type of immunotherapy that has shown promise in the treatment of colorectal cancer, particularly for patients with microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR) metastatic colorectal cancer. These subtypes of colorectal cancer are characterized by genetic mutations that affect the DNA repair process, making them more likely to respond to immunotherapy. Nivolumab works by blocking the PD-1 pathway, which cancer cells often exploit to evade the immune system. By inhibiting this pathway, Opdivo can help the immune system recognize and attack cancer cells more effectively.

In clinical trials, Nivolumab has demonstrated a significant improvement in overall survival and progression-free survival in patients with MSI-H or dMMR metastatic colorectal cancer compared to standard chemotherapy. The efficacy of Opdivo is particularly notable in patients who have previously received treatment, offering a new line of defense against this aggressive form of cancer. The response rates and durability of response with Nivolumab have been encouraging, leading to its approval by regulatory agencies for this indication.

Lonsurf (trifluridine/tipiracil) in Colorectal Cancer

Lonsurf, a combination of trifluridine and tipiracil, is an oral chemotherapy approved for the treatment of patients with metastatic colorectal cancer who have been previously treated with chemotherapy and biological therapy. Trifluridine is a nucleoside analog that gets incorporated into DNA, leading to inhibition of tumor growth, while tipiracil increases the bioavailability of trifluridine by inhibiting its degradation. This combination results in enhanced antitumor effects.

Clinical trials have shown that Lonsurf can extend overall survival in patients with metastatic colorectal cancer after standard therapies have failed. The RECOURSE trial, a pivotal phase III study, demonstrated that patients treated with Lonsurf had a median overall survival benefit compared to placebo. While the improvement in survival is modest, Lonsurf provides an important treatment option for patients with limited alternatives, offering potential for improved quality of life and additional time for patients and their families. The drug is generally well-tolerated, with manageable side effects, making it a viable option for patients who have exhausted other treatments.