There are many treatment options
Immuno-oncology
Immuno-oncology is a type of biological-therapy. Biologics include a wide range of substances from animal products and other living sources (as opposed to chemically manufactured medications) to prevent, diagnose or treat disease.
Immuno-oncology is a type of cancer treatment that helps your immune system fight cancer. In general, the immune system helps your body fight infections and other diseases. It is made up of white blood cells and organs and tissues of the lymph system. Immuno-oncology is the newest tool in the treatment of metastatic colorectal cancer.
Currently immuno-oncology is FDA approved for patients with metastatic colorectal cancer whose tumors have a feature called microsatellite instability (MSI-H) and have progressed on other standard chemotherapy for colorectal cancer. Only a small percentage of metastatic colorectal cancer are MSI-H, and there are many trials to find other strategies to use immuno-oncology in those tumors that are not MSI-H. You can discuss with your doctor if you should enroll in a clinical trial to test one of the experimental immuno-oncology strategies.
Although rare some serious life threatening side effects can occur, if you experience any of the following notify your healthcare team immediately:
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Lung problems (pneumonitis) symptoms may include:
- shortness of breath
- chest pain
- new or worse cough
-
Intestinal problems (colitis) symptoms may include:
- diarrhea or more bowel movements than usual
- stools that are black, tarry, sticky, or have blood or mucus
- severe stomach-area (abdomen) pain or tenderness
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Liver problems (hepatitis) symptoms may include:
- yellowing of your skin or the whites of your eyes
- nausea or vomiting
- pain on the right side of your stomach area (abdomen)
- dark urine
- feeling less hungry than usual
- bleeding or bruising more easily than normal
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Hormone producing gland problems symptoms may include:
- rapid heartbeat
- weight loss or weight gain
- increased sweating
- feeling more hungry or thirsty
- urinating more often than usual
- hair loss
- feeling cold
- constipation
- your voice gets deeper
- muscle aches
- dizziness or fainting
- headaches that will not go away or unusual headache
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Kidney problems, nephritis or kidney failure signs may include:
- Change in the amount or color of your urine.
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Inflammation of the brain (encephalitis) symptoms may include:
- headache
- fever
- tiredness or weakness
- confusion
- memory problems
- sleepiness
- seeing or hearing things that are not really there (hallucinations)
- seizures
- stiff neck
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Problems in other organs symptoms may include:
- rash
- changes in eyesight
- severe or persistent muscle or joint pains
- severe muscle weakness
- low red blood cells (anemia)
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Infusion (IV) reactions that can sometimes be severe and life-threatening symptoms may include:
- chills or shaking
- shortness of breath or wheezing
- itching or rash
- flushing
- dizziness
- fever
- feeling like passing out
Immunotherapies that have been tested in colorectal cancer
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Pembrolizumab (Keytruda)
Pembrolizumab is a humanized monoclonal antibody that binds to the PD-1 receptor and blocks its interaction with PD-L1 and PD-L2, thereby inhibiting inhibition of the immune response, including anti-tumor immune response. Pembrolizumab is FDA approved for colorectal cancers that are MSI-H in patients with colorectal cancer that has progressed following treatment with a fluoropyrimidine, oxaliplatin, and irinotecan.
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Nivolumab (Opdivo)
Nivolumab is a fully human monoclonal antibody that binds to the PD-1 receptor and blocks its interaction with PD-L1 and PD-L2, thereby inhibiting inhibition of the immune response, including anti-tumor immune response. Nivolumab is now FDA approved for colorectal cancer.
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