Myriam Chalabi
Led NICHE-2, in which almost every mismatch-repair-deficient colon cancer responded to short pre-surgery immunotherapy.
Myriam Chalabi's NICHE and NICHE-2 trials showed that brief neoadjuvant nivolumab plus ipilimumab produces pathological responses in nearly all dMMR colon cancers, reshaping the treatment paradigm.
| Title | Journal | Year |
|---|---|---|
| Neoadjuvant immunotherapy in locally advanced mismatch repair-deficient colon cancer (NICHE-2) | NEJM | 2024 |
For colon cancer that is mismatch-repair deficient (about 10-15% of colon cancers, more in older patients), a single short course of immunotherapy before surgery is now a reasonable standard and is far more effective than chemotherapy, which barely works in this subtype. It requires testing every colon cancer for mismatch repair at diagnosis, before surgery. Whether some patients can safely skip surgery, as in dMMR rectal cancer, is the next question.
NICHE-2 shows that a month of immunotherapy before surgery can effectively cure locally advanced dMMR colon cancer, where chemotherapy after surgery has limited benefit. It is changing guidelines towards neoadjuvant checkpoint blockade for this group and raises the question of whether surgery can be omitted altogether, as in dMMR rectal cancer. Whether the same applies to MMR-proficient tumours is being tested but is not established.
Pages like this
not linked directly; found by shared links- PersonChristian Blank
Shares Use pre-surgery immunotherapy windows as the field's biomarker engine, Netherlands Cancer Institute (NKI-AvL), Ipilimumab, Nivolumab.
- PairingNeoadjuvant checkpoint inhibitor → surgery (or no surgery) in dMMR colorectal cancer
Shares NICHE-2, Microsatellite instability (MSI-H) / mismatch repair deficiency (dMMR), Ipilimumab, Nivolumab.
- TrialCheckMate 8HW
Shares Microsatellite instability (MSI-H) / mismatch repair deficiency (dMMR), Ipilimumab, Nivolumab, Colorectal cancer.
- TrialNADINA
Shares Use pre-surgery immunotherapy windows as the field's biomarker engine, Netherlands Cancer Institute (NKI-AvL), Ipilimumab, Nivolumab.
- PersonTon Schumacher
Shares NICHE-2: a single dose of ipilimumab and two of nivolumab before surgery clears dMMR colon cancer in most patients, NICHE-2: a month of nivolumab and ipilimumab before surgery clears mismatch-repair-deficient colon cancer in most patients, Netherlands Cancer Institute (NKI-AvL).
- PersonJohn Haanen
Shares NICHE-2: a month of nivolumab and ipilimumab before surgery clears mismatch-repair-deficient colon cancer in most patients, Netherlands Cancer Institute (NKI-AvL), Ipilimumab.
- PersonEmile Voest
Shares NICHE-2: a month of nivolumab and ipilimumab before surgery clears mismatch-repair-deficient colon cancer in most patients, Netherlands Cancer Institute (NKI-AvL).
- TrialCheckMate 816
Shares Use pre-surgery immunotherapy windows as the field's biomarker engine, Nivolumab.