{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:28:18Z","timestamp":1792787298738,"version":"4.5.0"},"reference-count":43,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"content-version":"unspecified","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"The Andrew Sabin Family Fellowship Award at The University of Texas MD Anderson Cancer Center","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"https:\/\/ror.org\/04twxam07","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Col. Daniel Connelly Memorial Fund","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"name":"The National Cancer Institute Cancer Center Support Grant","award":["P30 CA016672"],"award-info":[{"award-number":["P30 CA016672"]}]},{"name":"The Cancer Prevention & Research Institute of Texas","award":["RR180035 & RP240392"],"award-info":[{"award-number":["RR180035 & RP240392"]}],"id":[{"id":"https:\/\/ror.org\/0003xa228","id-type":"ROR","asserted-by":"crossref"}]},{"name":"the Appendiceal Cancer Pseudomyxoma Peritonei Research Foundation","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Immunother Cancer"],"accepted":{"date-parts":[[2026,8,10]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Immune checkpoint inhibitors (ICIs) have limited efficacy in proficient mismatch repair\/microsatellite stable (pMMR\/MSS) metastatic colorectal cancer (mCRC). However, selected patients with specific metastatic patterns may derive benefit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with chemorefractory pMMR\/MSS mCRC treated with ICI-based regimens were retrospectively identified. A comparison cohort treated with trifluridine\/tipiracil\u00b1bevacizumab, regorafenib, or fruquintinib as standard of care (SOC) was generated through 1:1 propensity score matching by age, sex, Eastern Cooperative Oncology Group performance status (ECOG PS), liver metastases (present\/absent), and RAS\/BRAF status. Overall survival (OS) was compared using Cox regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 354 patients treated with ICIs and 354 treated with SOC were matched. Median age was 55 years, 52% male, 32% ECOG PS 0, 30% right-sided, and 69% RAS mutated in both groups, while 61% and 60% had liver metastases, respectively. Median OS (mOS) was 10.8 months with ICIs and 9.0 months with SOC (HR 0.76, 95%\u2009CI 0.64 to 0.92, p=0.004). In patients without liver metastases, mOS was longer with ICIs than SOC (19.1 vs 13.2 months, HR 0.59, 95%\u2009CI 0.43 to 0.80, p&lt;0.001), whereas outcomes were similar in patients with liver metastases (6.4 vs 6.5 months, p=0.303). In univariable analyses, age, sex, primary tumor site, and\n                      <jats:italic>RAS<\/jats:italic>\n                      \/\n                      <jats:italic>BRAF<\/jats:italic>\n                      status were not associated with OS. Treatment with ICIs, absence of liver metastases, one prior line of therapy, less than three metastatic sites, and ECOG PS 0 were associated with the most favorable outcomes in univariable and multivariable models.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In chemorefractory pMMR\/MSS mCRC without liver metastases, ICI-based regimens yielded longer OS than SOC. Further investigation of ICIs in this patient population is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/jitc-2026-015414","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T15:05:14Z","timestamp":1788361514000},"page":"e015414","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Overall survival of immunotherapy versus standard of care in chemorefractory microsatellite stable metastatic colorectal cancer: a propensity score matched analysis of 708 patients"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6943-2897","authenticated-orcid":false,"given":"Guglielmo","family":"Vetere","sequence":"first","affiliation":[{"name":"Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, 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