Oncology

Sintilimab plus long-course CRT achieves high pCR in Immunoscore-selected pMMR LARC

In the single-arm phase II SILAR trial, 46 pMMR LARC patients with intermediate/high Immunoscore received long-course CRT with mFOLFOX6 plus sintilimab during cycles 2–6. The pCR rate was 65.2%, higher in high-Immunoscore tumors (85.7%) than in intermediate-Immunoscore tumors (61.5%). R0 resection was achieved in 97.8% and clinical response rate was 93.5%, with leukopenia the most common toxicity and 15.2% grade 3 TRAEs. Postoperative complications were infrequent and low grade, while 3-year survival outcomes remain immature. 1

Reconstructed ATOMIC data suggest adjuvant atezolizumab may help both dMMR and pMMR stage III colon cancer

Reconstructed IPD from ATOMIC confirmed improved DFS with adjuvant atezolizumab plus chemotherapy versus chemotherapy alone in centrally confirmed dMMR stage III colon cancer. Three-year DFS was 86.2% with chemo-immunotherapy versus 77.0% with chemotherapy (HR 0.52, 95% CI 0.36–0.77) in dMMR disease. In an approximated pMMR subgroup, DFS numerically favored chemo-immunotherapy (3-year DFS 87.1% vs 77.4%; HR 0.45, 95% CI 0.16–1.27). The non-significant treatment-by-MMR interaction (Pinteraction=0.808) suggests similar relative benefit, but prospective validation in true pMMR cohorts is needed. 2

NALIRIFOX prolongs PFS versus gemcitabine/nab-paclitaxel in metastatic pancreatic adenocarcinoma

This randomized phase II trial enrolled 117 Chinese patients with unresectable metastatic pancreatic adenocarcinoma to first-line NALIRIFOX or gemcitabine plus nab-paclitaxel. With median follow-up 18.7 versus 12.1 months, NALIRIFOX improved median PFS to 7.6 versus 3.7 months (HR 0.56, 95% CI 0.35–0.88; P=0.0115). Grade ≥3 TEAEs occurred in 73.1% versus 84.6%, indicating similarly high but manageable toxicity for both intensive regimens. Despite early termination before the planned sample size, findings support NALIRIFOX as a more effective first-line option in this population. 3

Cost-effectiveness of adjuvant immunotherapy is common but context-dependent

This systematic review synthesized 69 full economic evaluations of adjuvant immunotherapy across multiple cancers published from 2015 to 2025. Most studies assessed first-line single-agent checkpoint inhibitors, often in NSCLC and melanoma, using Markov models and EQ-5D utilities. Adjuvant immunotherapy yielded higher QALY or life-year gains in 91% of analyses, especially in NSCLC, combination regimens, and industry-funded studies. However, only 58% judged adjuvant immunotherapy cost-effective, with conclusions strongly influenced by cancer type, drug prices, thresholds, and model assumptions. 4