Dr. Van Morris Answers Questions About Colorectal Cancer and Immunotherapy at the 2021 CRI Virtual Immunotherapy Patient Summit

At the CRI Virtual Immunotherapy Patient Summit in October, patients and caregivers were eager to further their understanding of immunotherapy for colorectal cancer.

Van Morris, MD, assistant professor in the Department of Gastrointestinal Medical Oncology at the University of Texas MD Anderson Cancer Center, led the Colorectal Cancer and Immunotherapy session.

We followed up with Dr. Morris after the event to discuss several more questions from attendees.

If my husband has been in remission from colorectal cancer for three to five years, should he consider immunotherapy for prevention?

There isn’t any indication that patients who have not had their cancer come back should start immunotherapy as a “prevention” so I would not recommend any additional treatment at present.

I am on maintenance therapy, which they say I will have to do for the rest of my life. Is that correct in your experience?  How long have you had patients on maintenance treatment?

I have had patients remain on maintenance therapy for different amounts of time, several of whom have been on maintenance for over 12 months.  We do see that some patients take breaks from maintenance chemo, and always discuss the pros and cons of extended breaks based on how the patient is doing.

Is there research being done on how to better identify and treat immunotherapy side effects in the near future?  I am on immunotherapy and have had some issues with gastritis.

Yes – as exciting as immunotherapy is in terms of helping people living with cancer, we do have to be mindful of some, though rare, side effects that people may experience.  Understanding why some people experience heavy side effects and others may experience no symptoms at all is very important and not yet fully understood.  This research in understanding side effects is under active investigation, with the ultimate goal of improving the overall tolerability for as many patients as possible.

If you have had significant side effects (colitis and inflammatory arthritis) from immunotherapy and need to stop immunotherapy for 6 months, can you resume treatment afterward? Will that impact how effective the treatment is?

In some cases, treatment can be started back without seeing the side effects of immunotherapy return.  In other cases, the side effects do return.  Some organ sites are more likely than others for the side effects to come back.  If a patient can tolerate the treatment safety when treatment is restarted, oftentimes they experience the same benefit in terms of controlling cancer with immunotherapy.

I had gene sequencing three years ago after colorectal cancer stage 4 was found (no tumor) with TMB 19+.  Chemo was a disaster.  I'm now on a checkpoint inhibitor and it seems to have held the cancer off.  Should I ask for a new sequencing? 

Sometimes the sequencing results can change over time.  If you are benefitting from the treatment and otherwise tolerating treatment well, I don’t know that I would use the results of any new sequencing to change your treatment plan, but it could potentially be informative to see how sequencing profiles may have evolved.

Learn more about immunotherapy for colorectal cancer