Immunotherapy for precision medicine in colorectal cancer.

Introduction: Colorectal cancer (CRC) is the fourth most common cancer and second leading cause of cancer-related death in the United States. The implementation of CRC screening has decreased CRC incidence in adults older than 65 years. However, among young adults who experience more aggressive disease progression, CRC incidence has been increasing for decades. Immunotherapy represents a collection of innovative and promising approaches with greater efficacy and safety. In this review, we discuss modalities and selected targets of immunotherapies for CRCs that are guided by precision medicine. Areas covered: The following review focuses on immunological approaches for CRCs, including therapeutic monoclonal antibodies, immune checkpoint blockade, cancer vaccines, and adoptive cell therapies. Expert opinion: Metastatic and refractory CRCs are significant causes of cancer-related mortality and remain difficult to treat with current standard therapies. Following multiple FDA approvals for hematologic malignancies, research into solid tumor immunotherapies has substantially increased. Several chimeric antigen receptor (CAR)-expressing T cell therapies are showing promise in CRC. Moreover, immune checkpoint blocking antibodies are transforming care for a subset of CRC patients. With advances in our understanding of oncogenic mechanisms and development of novel treatment approaches, personalized immunotherapies are poised to dramatically change the landscape of CRC treatment.