Advances in the combination of immunotherapy and radiotherapy for microsatellite-stable metastatic colorectal cancer

Combining immunotherapy with radiotherapy has emerged as a novel and promising approach for treating microsatellite-stable metastatic colorectal cancer (MSS mCRC). This review offers an in-depth analysis of recent advancements in the field, with particular emphasis on several critical dimensions. Initially, we explore the epidemiological landscape of MSS mCRC, underscoring its incidence and distinctive clinical features. Subsequently, the mechanisms through which MSS colorectal cancer evades immune detection are scrutinized, detailing how these tumors manipulate immune surveillance to foster an immunosuppressive tumor microenvironment. Additionally, we delve into the principal pathways and molecular signatures by which radiotherapy potentiates immune efficacy, notably its capacity to reshape the tumor microenvironment and stimulate immune responsiveness. Moreover, we critically evaluate existing clinical trials integrating immunotherapy with radiotherapy for MSS mCRC, stressing the necessity of identifying predictive biomarkers indicative of immune sensitivity. Lastly, we underscore the potential of personalized therapeutic strategies, guided by precise biomarker profiling, to enhance both patient quality of life and clinical outcomes. Collectively, this review presents a thorough examination of current research developments and outlines future perspectives within the realm of combined immunotherapy and radiotherapy for MSS mCRC.