©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 26, 2025; 13(33): 113216
Published online Nov 26, 2025. doi: 10.12998/wjcc.v13.i33.113216
Published online Nov 26, 2025. doi: 10.12998/wjcc.v13.i33.113216
When new therapies arrive, we should think more: The unseen challenges of immunotherapy-induced remodeling
Rui Gang Wang, Department of Gastroenterology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, Beijing 102218, China
Author contributions: Wang RG contributed to the design, drafting, revision, and review of the manuscript content.
Supported by Beijing Tsinghua Changgung Hospital Youth Fund, No. 12021C1011.
Conflict-of-interest statement: The author reports no relevant conflicts of interest for this article.
Corresponding author: Rui Gang Wang, Department of Gastroenterology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, No. 168 Litang Road, Changping District, Beijing 102218, China. doctorwrg@163.com
Received: August 19, 2025
Revised: August 30, 2025
Accepted: October 27, 2025
Published online: November 26, 2025
Processing time: 94 Days and 13.3 Hours
Revised: August 30, 2025
Accepted: October 27, 2025
Published online: November 26, 2025
Processing time: 94 Days and 13.3 Hours
Core Tip
Core Tip: The unprecedented case of spontaneous colonic transection after pathological complete response to pembrolizumab in microsatellite instability-high colorectal cancer highlights a critical blind spot in immune oncology. While immune checkpoint inhibitors achieve remarkable tumor regression, they can induce profound bowel wall damage invisible to conventional imaging. This editorial calls for urgent multidisciplinary action: Re-evaluating surgical timing and techniques in immunotherapy responders, developing novel biomarkers to predict bowel wall integrity, and implementing enhanced surveillance protocols to prevent catastrophic complications from delayed tissue toxicity.