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A short course of neoadjuvant immunotherapy continues to show long-term outcomes in patients with locally advanced mismatch repair–deficient (dMMR) colon cancer. In the NICHE-2 study, none of the 111 patients in the primary efficacy population experienced disease recurrence, and all were alive at their most recent follow-up. The findings, now published in The Lancet, provide further evidence of the durability of response to neoadjuvant immunotherapy in this patient population.

The phase 2 NICHE-2 study investigated neoadjuvant nivolumab and ipilimumab in patients with nonmetastatic dMMR colon cancer. Patients received two cycles of immunotherapy over approximately four weeks, followed by surgery.

Earlier findings demonstrated a pathological response in 98% of patients, including a pathological complete response in 68%. Three-year follow-up results had already shown no disease recurrences in the primary efficacy population.

The latest analysis extends these observations, with a median postoperative follow-up of 58.7 months. No recurrences were observed among the 111 patients in the primary efficacy population, and all patients were alive at their most recent follow-up. The three-year disease-free survival rate was 100%, while the estimated five-year overall survival rate was also 100%.

"These long-term data are particularly important because the ultimate goal is not just to induce a strong pathological response, but to achieve durable disease control," says Myriam Chalabi, a medical oncologist at the Netherlands Cancer Institute.

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