Efficacy of sintilimab combined with neoadjuvant chemotherapy in treatment of patients with locally advanced colorectal cancer

Lian Rui; Ning Yaojun; Xie Dashuai; Gong Yanmei; Shi Ping

doi:10.3969/j.issn.1672-8157.2025.03.016

Abstract：Objective To explore the efficacy of sintilimab combined with neoadjuvant chemotherapy in treatment of patients with locally advanced colorectal cancer.Methods A total of 164 patients with locally advanced colorectal cancer who were admitted to Yuncheng Central Hospital,Shanxi Medical University from June 2020 to May 2022 were selected as study subjects and randomly divided into the immunotherapy group and the chemotherapy group,with 82 cases in each group.The chemotherapy group was treated with neoadjuvant chemotherapy and the immunotherapy group was combined with sin-tilimab on the basis of the chemotherapy group.The recent outcomes,serum epidermal growth factor receptor,vascular en-dothelial growth factor,soluble intercellular adhesion molecule levels and the occurrence of adverse reactions,and post-treat-ment surgery and survival were observed.Results The objective remission and disease control rates of the immunotherapy group were 51.60%(46/82)and 91.46%(75/82),respectively,higher than 39.02%(32/82)and 78.05%(64/82)of the chemo-therapy group(χ2=4.792,5.711,both P<0.05).The serum epidermal growth factor receptor,vascular endothelial growth fac-tor,and soluble intercellular adhesion molecule 1 levels of the immunotherapy group were respectively(5.25±2.37)mg·L-1,(218.45±116.32)pg·mL-1 and(175.12±34.32)ng·mL-1 after the treatment,lower than(8.12±4.24)mg·L-1,(284.12±112.54)pg·mL-1 and(238.46±68.76)ng·mL-1 of the chemotherapy group(t=5.350,3.674,7.464,all P<0.05).The total incidence of adverse reactions was 28.05%(23/82)in the chemotherapy group,32.93%(27/82)in the immunotherapy group,and there was no significant differ-ence(P>0.05).Radical surgery was feasible in 73 patients(89.02%)of the immunotherapy group after the treatment,more than 62 patients(75.61%)of the chemotherapy group.The R0 resection rate of the immunotherapy group was 85.37%(70/82),higher than 69.51%(57/82)of the chemotherapy group(χ2=5.069,5.898,both P<0.05).Prophylactic ostomy was performed in 26 patients(31.71%)of the immunotherapy group,less than 39 patients(47.56%)of the chemotherapy group(χ2=4.307,P<0.05).With fol-low-up until November 30,2024 and no loss to follow-up,the median progression-free survival of the immunotherapy group was 15.0 months,longer than 13.0 months of the chemotherapy group(Log-rank χ2=9.228,P<0.05).The median OS of the immunother-apy group was 18.0 months and that of the chemotherapy group was 15.5 months,and there was no significant difference(P>0.05).Conclusion Sintilimab combined with neoadjuvant chemotherapy significantly improves the near-term efficacy of locally advanced colorectal cancer,reduces the levels of serum epidermal growth factor receptor,vascular endothelial growth factor and soluble inter-cellular adhesion molecule,improves surgical resection rate,and prolongs survival with manageable adverse reactions.