Inside a lifesaving 'last resort' clinical trial—have we finally solved the problem of chemo-resistant colon cancer?
Key Takeaways
Industry Buzz
"Some of the targets inside the cell are preventing the immune system from activating against the cancer. It’s kind of like a shield that protects the cancer cell from the body’s immune system." — Emil Lou, MD, medical oncologist and scientist
When Emma Dimery, 35, was told her stage IV colon cancer was terminal, she’d exhausted nearly every standard treatment option—surgery, multiple rounds of chemotherapy, radiation, and immunotherapy. None worked.
That’s when she enrolled in a small clinical trial at the University of Minnesota, led by oncologist Emil Lou, MD, that ultimately reversed her disease course. []
Targeting the cancer cell’s immune cloaking system
Unlike standard immunotherapies that target extracellular markers like PD-1 or CTLA-4, this trial focused on an intracellular mechanism used by tumor cells to evade immune detection.
According to Dr. Lou, cancer cells in colorectal tumors often produce immune-suppressive signals from within that effectively “turn off” T cells before they can launch an attack.
The investigational drug in this trial disrupts one of these intracellular escape pathways—though exact molecular targets have not been publicly disclosed.
By disabling this pathway, the immune system is no longer suppressed, allowing cytotoxic T cells to identify and destroy tumor cells. Dimery reportedly showed complete response within weeks.
Related: Often seen as waste, stool may yield clues to microbiome’s role in cancer treatmentTrial details
Institution: University of Minnesota Medical School
Phase: Early-stage (likely Phase I or II)
Inclusion criteria: Advanced or refractory colorectal cancer unresponsive to conventional therapies
Mechanism: Modulation of intracellular immune evasion signals
Endpoints: Safety, tolerability, immune response activation, and progression-free survival
Why this matters for oncologists
This trial underscores two critical shifts in oncology:
A move beyond checkpoint inhibitors: For tumors like colorectal adenocarcinoma, particularly those that are microsatellite stable (MSS), checkpoint blockade often fails. By targeting the internal mechanisms of immune evasion rather than external checkpoint proteins, this therapy represents a new class of immunotherapy potentially applicable to MSS tumors, which comprise the majority of colorectal cancers.
Personalized, immune-informed treatment plans: As more patients fail standard lines of therapy, oncologists may increasingly need to explore trials targeting individual tumor immunogenomics. The case also highlights the urgency of referring patients earlier to clinical trial programs—not just as a last resort.
Next steps and cautions
While Dimery’s remission is compelling, oncologists should interpret it cautiously:
Sample size remains extremely small; the trial is in early stages.
Long-term efficacy and safety data are pending.
Mechanistic transparency is limited, so it’s unclear whether the observed response will generalize across tumor types or patient populations.
Still, for oncologists treating heavily pretreated colorectal cancer patients, this case highlights the value of exploring immune-oncology research beyond the usual suspects.
Related: I was diagnosed with colon cancer in my 30s: Here's how I'm coping today