Trials in Progress Update: The COMMIT Study (NRG-GI004/SWOG S1610)

March 12 2024

The COMMIT Study (NRG-GI004/SWOG S1610): Colorectal Cancer Metastatic dMMR Immuno-Therapy (COMMIT) Study: A Randomized Phase III Study of mFOLFOX6/Bevacizumab Combination Chemotherapy with or without Atezolizumab or Atezolizumab Monotherapy in the First-Line Treatment of Patients with Deficient DNA Mismatch Repair (dMMR) Metastatic Colorectal Cancer

Metastatic colorectal cancer poses significant challenges in treatment, particularly in cases characterized by microsatellite instability-high (MSI-H), which accounts for approximately 5% of metastatic colorectal cancers. While immunotherapy has shown promise in this subgroup, its efficacy as a standalone treatment remains variable with many patients failing to derive benefit, prompting exploration of combination strategies.

Combining atezolizumab immunotherapy with FOLFOX chemotherapy plus antiangiogenic therapy with bevacizumab present a potential strategy to enhance treatment outcomes by leveraging synergistic mechanisms of actions: directed cell destruction with chemotherapy, immunogenic cell death with atezolizumab, and modulating the tumor microenvironment with bevacizumab. The NRG-GI004/SWOG S1610 study represents a pivotal endeavor aimed at investigating the efficacy of this combination regimen, FOLFOX+bevacizumab+ atezolizumab in comparison to atezolizumab alone in patients with metastatic colon cancer harboring MSI-H. 

The trial is enrolling patients with deficient dMMR/MSI-H mCRC who have not received prior systemic treatment and will stratify these patients by BRAF mutation status, metastatic disease, and any prior adjuvant therapy for colon cancer. Following stratification, these patients will be randomized 1:1 to one of two treatment arms: atezolizumab immunotherapy alone or atezolizumab in combination with traditional mFOLFOX6 with bevacizumab. All patients continue their treatment until disease progression and/or an unacceptable toxicity.

Positive outcomes from this study could revolutionize treatment paradigms for MSI-H metastatic colon cancer, establishing combined immunotherapy, antiangiogenic therapy, and chemotherapy as a standard of care. We are currently 23 patients short of completing our accrual goal and you can help!

Learn more about The COMMIT Study.

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