The therapeutic and prognostic implications of immunobiology in colorectal cancer: a review

Abstract

Colorectal cancer represents the second leading cause of cancer-related death worldwide. The therapeutic field of immuno-oncology has rapidly gained momentum, with strikingly promising results observed in clinical practice. Increasing emphasis has been placed on the role of the immune response in tumorigenesis, therapy and predicting prognosis. Enhanced understanding of the dynamic and complex tumour-immune microenvironment has enabled the development of molecularly directed, individualised treatment. Analysis of intra-tumoural lymphocyte infiltration and the dichotomisation of colorectal cancer into microsatellite stable and unstable disease has important therapeutic and prognostic implications, with potential to capitalise further on this data. This review discusses the latest evidence surrounding the tumour biology and immune landscape of colorectal cancer, novel immunotherapies and the interaction of the immune system with each apex of the tripartite of cancer management (oncotherapeutics, radiotherapy and surgery). By utilising the synergy of chemotherapeutic agents and immunotherapies, and identifying prognostic and predictive immunological biomarkers, we may enter an era of unprecedented disease control, survivorship and cure rates.

An integrative in-silico analysis discloses a novel molecular subset of colorectal cancer possibly eligible for immune checkpoint immunotherapy

“…The existence of a small group of pMMR/MSS CRCs (~ 10%) responsive to ICIs therapies has been inferred in several clinical studies [ 39 – 41 ]. Pagès and collaborators observed a high immunoscore in 21% of MSS compared to 45% of MSI [ 42 ].…”

The Effect of Liposomal Diallyl Disulfide and Oxaliplatin on Proliferation of Colorectal Cancer Cells: In Vitro and In Silico Analysis

“…In clinical settings, the primary treatment for CRC is surgical resection, but subsequently, it requires chemotherapy to avoid the risk of recurrence, as it cannot be eradicated completely [5][6][7]. The therapeutic strategies of CRC, which include radiation, surgery, immunotherapy, and chemotherapy, also have certain limitations due to cancer recurrence, drug resistance, and toxicity [8][9][10][11][12]. The development of these outcomes has been shown to be associated with a single-drug therapeutic approach, while the process of carcinogenesis is commonly linked to multiple signaling pathways [13][14][15][16].…”

Lipid-Based Nanoparticle Formulation of Diallyl Trisulfide Chemosensitizes the Growth Inhibitory Activity of Doxorubicin in Colorectal Cancer Model: A Novel In Vitro, In Vivo and In Silico Analysis

“…Therefore, surgical removal followed by chemotherapy is the initial treatment choice in CRC, though it is not eradicated totally [ 5 , 6 , 7 ]. The use of chemotherapeutic agents, monoclonal antibodies, radiation therapy, and surgery have shown limitations, as resistance to drugs, side effects, and cancer recurrence was recorded by these therapeutics [ 8 , 9 , 10 , 11 , 12 ]. However, the initiation, promotion, and progression of all types of cancer, including CRC, have been associated with multiple signalling pathways, weakening the treatment strategies based on a single drug or targeting a single gene [ 13 , 14 , 15 ].…”