{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:00:14Z","timestamp":1778198414082,"version":"3.51.4"},"reference-count":10,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:00:00Z","timestamp":1769040000000},"content-version":"unspecified","delay-in-days":21,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Noncommunicable Chronic Diseases-National Science and Technology Major Project","award":["2023ZD0501600"],"award-info":[{"award-number":["2023ZD0501600"]}]},{"DOI":"10.13039\/501100002858","name":"China Postdoctoral Science Foundation","doi-asserted-by":"publisher","award":["GZC20230961"],"award-info":[{"award-number":["GZC20230961"]}],"id":[{"id":"10.13039\/501100002858","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003453","name":"Natural Science Foundation of Guangdong Province","doi-asserted-by":"publisher","award":["2024A1515012980"],"award-info":[{"award-number":["2024A1515012980"]}],"id":[{"id":"10.13039\/501100003453","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003453","name":"Natural Science Foundation of Guangdong Province","doi-asserted-by":"publisher","award":["2025B1515020081"],"award-info":[{"award-number":["2025B1515020081"]}],"id":[{"id":"10.13039\/501100003453","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Yangfan Special Project of Shanghai Qimingxing Program","award":["22YF1459200"],"award-info":[{"award-number":["22YF1459200"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82303866"],"award-info":[{"award-number":["82303866"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82473362"],"award-info":[{"award-number":["82473362"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Young Elite Scientists Sponsorship Program by CAST","award":["2023QNRC001"],"award-info":[{"award-number":["2023QNRC001"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Immunother Cancer"],"accepted":{"date-parts":[[2026,1,9]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>\n                    The phase III ATOMIC trial recently showed that adding atezolizumab to standard adjuvant chemotherapy improved disease-free survival (DFS) in patients with mismatch-repair-deficient (dMMR) stage III colon cancer; however, its efficacy in mismatch-repair-proficient (pMMR) disease remains unknown. To address this issue, we reconstructed individual patient-level survival data (IPD) for the centrally confirmed dMMR subgroup, as well as those without centrally confirmed dMMR status (an approximation of the pMMR subgroup) in ATOMIC. The analysis of reconstructed IPD faithfully reproduced the trial\u2019s reported DFS gain by adding atezolizumab to adjuvant chemotherapy in the dMMR subgroup (3-year DFS, 86.2% vs 77.0%; HR, 0.52 (95% CI 0.36 to 0.77)). Intriguingly, DFS was also in favor of the chemo-immunotherapy arm in the approximated pMMR subgroup (3-year DFS, 87.1% vs 77.4%; HR, 0.45 (95% CI 0.16 to 1.27)). The interaction test further demonstrated that treatment effect did not differ by MMR status (P\n                    <jats:sub>interaction<\/jats:sub>\n                    =0.808). These findings raise the possibility that adjuvant chemo-immunotherapy may confer benefit even in pMMR stage III colon cancer, which underscores the need for prospective validation in this population.\n                  <\/jats:p>","DOI":"10.1136\/jitc-2025-013791","type":"journal-article","created":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T14:25:17Z","timestamp":1769091917000},"page":"e013791","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Adjuvant chemo-immunotherapy shows comparable efficacy among mismatch-repair-deficient and mismatch-repair-proficient stage III colon cancer: an exploratory, reconstructed individual patient-level data analysis"],"prefix":"10.1136","volume":"14","clinical-trial-number":[{"clinical-trial-number":"nct00026273","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct00112918","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct03026140","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct01918527","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Yu-Tong","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Pathology, School of Medicine, Jinan University, Guangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruowei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying-Ting","family":"Situ","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei-Feng","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4703-3486","authenticated-orcid":false,"given":"Weili","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun-Zhong","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianhong","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7950-787X","authenticated-orcid":false,"given":"Zi-Xian","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,1,22]]},"reference":[{"key":"2026012206250950000_14.1.e013791.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2017699"},{"key":"2026012206250950000_14.1.e013791.2","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1016\/S0140-6736(24)02848-4","article-title":"Nivolumab plus ipilimumab versus nivolumab in microsatellite instability-high metastatic colorectal cancer (CheckMate 8HW): a randomised, open-label, phase 3 trial","volume":"405","author":"Andr\u00e9","year":"2025","journal-title":"The Lancet"},{"key":"2026012206250950000_14.1.e013791.3","doi-asserted-by":"crossref","unstructured":"Sinicrope FA , Ou F-S , Arnold D , et al . Randomized trial of standard chemotherapy alone or combined with atezolizumab as adjuvant therapy for patients with stage III deficient DNA mismatch repair (dMMR) colon cancer (Alliance A021502; ATOMIC). JCO 2025;43. doi:10.1200\/JCO.2025.43.17_suppl.LBA1","DOI":"10.1200\/JCO.2025.43.17_suppl.LBA1"},{"key":"2026012206250950000_14.1.e013791.4","doi-asserted-by":"crossref","first-page":"1150","DOI":"10.1016\/j.medj.2024.05.009","article-title":"First-line serplulimab in metastatic colorectal cancer: Phase 2 results of a randomized, double-blind, phase 2\/3 trial","volume":"5","author":"Wang","year":"2024","journal-title":"Med"},{"key":"2026012206250950000_14.1.e013791.5","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(22)00274-1"},{"key":"2026012206250950000_14.1.e013791.6","doi-asserted-by":"crossref","unstructured":"Zhao JJ , Syn NL , Tan BKJ . KMSubtraction: reconstruction of unreported subgroup survival data utilizing published Kaplan-Meier survival curves. BMC Med Res Methodol 2022;22. doi:10.1186\/s12874-022-01567-z","DOI":"10.1186\/s12874-022-01567-z"},{"key":"2026012206250950000_14.1.e013791.7","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(20)30527-1"},{"key":"2026012206250950000_14.1.e013791.8","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s40880-019-0400-x","article-title":"Safety and efficacy of a modified XELOX adjuvant regimen for patients with operated stage III colon cancer: a Chinese single\u2010center experience","volume":"39","author":"Peng","year":"2019","journal-title":"Cancer Commun"},{"key":"2026012206250950000_14.1.e013791.9","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2402604"},{"key":"2026012206250950000_14.1.e013791.10","doi-asserted-by":"crossref","unstructured":"Chalabi M , Verschoor YL , et al . Neoadjuvant immunotherapy in locally advanced mismatch repair\u2013deficient colon cancer. N. 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