[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-333766-105":59,"doc-detail-333766-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","clinical-status-and-future-prospects-of-neoadjuvant-immunotherapy-for-localized-mismatch-repair-deficient-cancers-a-review","Clinical status and future prospects of neoadjuvant immunotherapy for localized mismatch repair-deficient cancers - a review","","Frameshift mutations accumulate in cancers with mismatch repair deficiency (dMMR), enabling the production of diverse neoantigens and defining a subset of tumors with strong immunotherapy responsiveness. Evidence has expanded from first-line treatment of metastatic dMMR cancers to earlier, up-front strategies including neoadjuvant therapy. Completed small trials suggest high complete response rates, but clinicians must balance good established care for proficient MMR against limited follow-up data for neoadjuvant immunotherapy.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/clinical-status-and-future-prospects-of-neoadjuvant-immunotherapy-for-localized-mismatch-repair-deficient-cancers-a-review/333766/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/clinical-status-and-future-prospects-of-neoadjuvant-immunotherapy-for-localized-mismatch-repair-deficient-cancers-a-review/333766.png","ImageObject",300,407,{"name":92,"@type":93},"Theodore","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-10","2026-09-21",true,{"@type":102,"interactionType":103,"userInteractionCount":34},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why are dMMR cancers considered suitable for immunotherapy?","Question",{"text":112,"@type":113},"dMMR drives microsatellite instability and accumulation of frameshift mutations, which can generate many neoantigens and supports immunotherapy responsiveness.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What progress has been reported for neoadjuvant immunotherapy in localized dMMR cancers?",{"text":117,"@type":113},"Several small completed trials indicate neoadjuvant immunotherapy can produce impressively high complete response rates with relatively low severe adverse effects.",{"name":119,"@type":110,"acceptedAnswer":120},"What dilemma complicates choosing neoadjuvant immunotherapy for localized dMMR cancers?",{"text":121,"@type":113},"Clinicians must weigh established standard-of-care for proficient MMR against emerging immunotherapy results for dMMR, which are based on limited patients and shorter follow-up.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},333766,1790565990,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":34,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},7971461740886,"https://ap-avatar.wpscdn.com/davatar_3d24733baf745e90a7e4bdd5f77d97b2","’Review Article  \nClinical status and future prospects of neoadjuvant immunotherapy for localized mismatch repairdeficient cancers: a review  \nJian Li, MMed*  \nAbstract   \nFrameshift mutations accumulate in cancers related to mismatch repair deficiency (dMMR), which has the potential to produce various neoantigens, representing a distinct subset of cancers that respond considerably to immunotherapy. In recent years, robust evidence has supported the first-line application of immunotherapy for patients with metastatic dMMR cancers, which provoked extensive investigations of the feasibility and efficacy of immunotherapy in up-front settings, including neoadjuvant therapy. Several completed trials with small sample sizes suggested that neoadjuvant immunotherapy can achieve an impressively high complete response rate, for the first time offering the potential of systemic therapy to cure cancer without the need for surgical resection. However, a difficult dilemma emerges: clinicians are now facing a selection between the standard of care with good evidence for proficient MMR but suboptimal for dMMR cancers and the emerging immunotherapy with promising results but only based on a limited number of patients with shorter duration of follow-up. This review aims to provide a comprehensive summary of the biological rationale and clinical status of neoadjuvant immunotherapy in patients with dMMR cancers. Furthermore, I elaborate on particular issues that must be taken into consideration for further advancement in the field.  \nKeywords: immune checkpoint inhibitors, localized cancer, microsatellite instability, mismatch repair deficiency, neoadjuvant immunotherapy, nonoperative management  \nIntroduction  \nImmunotherapy has revolutionized the treatment paradigm for advanced-stage cancers, providing an unprecedented survival benefitin selected patients[1,2] . However, only a minority of patients are expected to respond to immunotherapy[3] . Therefore, the application of neoadjuvant immunotherapy in localized cancers has attracted much attention in recent years, aiming to activate more solid anticancer immunity against existing neoantigens. In both localized and metastatic settings, an issue impeding the successful application of immunotherapy is the lack of perfect biomarkers for stratifying patients, as not every patient responds equally. Therefore, identifying reliable biomarkers to select patients who are likely to benefit from immunotherapy has attracted much attention  \nDepartment of General Surgery, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, Sichuan, People ’s Republic of China  \nSponsorships or competing interests that maybe relevant to content are disclosed atthe end of this article.  \n*Corresponding author. Address: Department of General Surgery, The Third Hospital of Mianyang, No. 190 East Section of Jiannan Road, Youxian District, Sichuan 621000, People ’s Republic of China. Tel.: +86 133 308 939 77.  \n[E-mail: 654747973@qq.com](E-mail: 654747973@qq.com) (J. Li).  \nCopyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.  \nInternational Journal of Surgery (2024) 110:5722–5732  \nReceived 27 March 2024; Accepted 9 May 2024  \nPublished online 20 May 2024  \n[http://dx.doi.org/10.1097/JS9.0000000000001680](http://dx.doi.org/10.1097/JS9.0000000000001680)  \nHIGHLIGHTS  \n• In the past several years, several clinical trials on neoadjuvant immunotherapy for mismatch repair-deficient (dMMR) cancer have been published, offering systemic therapy to cure solid cancer without surgery for the first time.  \n• The comprehensive literature review of neoadjuvant immunotherapy for dMMR cancer is lacking, while this treatment paradigm may be a hot topic and will change the standard of therapy for lo","cbCaicvM4JjjSoOx","https://ap.wps.com/l/cbCaicvM4JjjSoOx","pdf",694405,11,"English","# Introduction\n## Rationale for neoadjuvant immunotherapy in localized dMMR cancers\n## Biomarkers and clinical challenges\n# Highlights and clinical status\n## Evidence from clinical trials\n## Safety, response, and resistance considerations\n# Biological rationale and future directions\n## Issues for advancing the field","[{\"question\":\"Why are dMMR cancers considered suitable for immunotherapy?\",\"answer\":\"dMMR drives microsatellite instability and accumulation of frameshift mutations, which can generate many neoantigens and supports immunotherapy responsiveness.\"},{\"question\":\"What progress has been reported for neoadjuvant immunotherapy in localized dMMR cancers?\",\"answer\":\"Several small completed trials indicate neoadjuvant immunotherapy can produce impressively high complete response rates with relatively low severe adverse effects.\"},{\"question\":\"What dilemma complicates choosing neoadjuvant immunotherapy for localized dMMR cancers?\",\"answer\":\"Clinicians must weigh established standard-of-care for proficient MMR against emerging immunotherapy results for dMMR, which are based on limited patients and shorter follow-up.\"}]","Clinical status and future prospects of neoadjuvant immunotherapy for localized mismatch repair-deficient cancers - a review | PDF",1790003939,28]