# Nivolumab in patients with metastatic DNA mismatch repair-deficient or microsatellite instability-high colorectal cancer (CheckMate 142)

Source: https://onco.cc/key-papers/paper-overman-checkmate-142-nivolumab-dmmr-colorectal-lancet-oncol-2017/  
OnCo record `paper-overman-checkmate-142-nivolumab-dmmr-colorectal-lancet-oncol-2017` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Seventy-four heavily pre-treated patients whose bowel cancers had lost DNA mismatch repair were given nivolumab; nearly a third responded and most of those responses were still going a year later.

## Summary

In this multicentre, open-label, phase 2 trial, adults with histologically confirmed mismatch repair deficient or microsatellite instability-high metastatic colorectal cancer received nivolumab, with investigator-assessed objective response by RECIST 1.1 as the primary endpoint. Of the 74 patients enrolled between March 2014 and March 2016, 40 (54%) had received three or more previous treatments. At a median follow-up of 12.0 months, 23 patients (31.1%) achieved an objective response and 51 (69%) had disease control for 12 weeks or longer. Median duration of response was not reached, all responders were alive, and 8 had responses lasting 12 months or longer. The most common grade 3 or 4 drug-related adverse events were raised lipase (8%) and amylase (3%), and none of the 23 deaths during the study was considered treatment related.

## Fields

- Kind: Key paper
- Last checked: 2026-09-24
- Journal: Lancet Oncology
- Year: 2017
- DOI: 10.1016/S1470-2045(17)30422-9
- Authors: Overman MJ, McDermott R, Leach JL, et al.
- Findings: Objective response in 23 of 74 patients (31.1%); disease control for 12 weeks or longer in 69%.; Median duration of response not reached; all responders alive at a median 12 months' follow-up.; Grade 3 or 4 drug-related events uncommon (raised lipase 8%).
- What it means: It gave the second PD-1 antibody a colorectal indication in mismatch repair deficient disease and, with the ipilimumab cohort that followed, set up CheckMate 8HW and the first-line combination.
- Caveats: Single-arm phase 2 with no control.; Investigator-assessed response.; Mismatch repair status was determined locally by several methods.

## Sources

- Overman et al., Lancet Oncol 2017: CheckMate 142, nivolumab in 74 patients with dMMR/MSI-high metastatic colorectal cancer: https://doi.org/10.1016/S1470-2045(17)30422-9
- PubMed: https://pubmed.ncbi.nlm.nih.gov/28734759/

## Connected records

- biomarkers: [dMMR (mismatch repair deficiency by IHC)](https://onco.cc/biomarkers/dmmr-ihc/), [MSI-high (microsatellite instability by PCR or sequencing)](https://onco.cc/biomarkers/msi-high/)
- cancers: [Colorectal cancer](https://onco.cc/cancers/colorectal/)
- technologies: [Immune checkpoint inhibitors](https://onco.cc/technologies/checkpoint-inhibitor/), [MSI and mismatch-repair testing](https://onco.cc/technologies/msi-mmr-testing/)
- targets: [Mismatch repair proteins (MLH1, MSH2, MSH6, PMS2)](https://onco.cc/targets/mmr/), [PD-1](https://onco.cc/targets/pd1/)
- drugs: [Nivolumab](https://onco.cc/drugs/nivolumab/)
- institutions: [MD Anderson Cancer Center](https://onco.cc/institutions/md-anderson/)
- pathways: [Mismatch repair & microsatellite instability](https://onco.cc/pathways/mismatch-repair-msi/), [PD-1 / PD-L1 immune checkpoint & T-cell activation](https://onco.cc/pathways/pd1-checkpoint/)
- terms: [Microsatellite instability (MSI-H) / mismatch repair deficiency (dMMR)](https://onco.cc/terms/msi/), [Tumour-agnostic (tissue-agnostic) approval](https://onco.cc/terms/tumour-agnostic/)
- trials: [CheckMate 8HW](https://onco.cc/trials/checkmate-8hw/)
- people: [Scott Kopetz](https://onco.cc/people/scott-kopetz/), [Thierry André](https://onco.cc/people/thierry-andre/)
- journals: [The Lancet Oncology](https://onco.cc/journals/lancet-oncology/)

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