Treatment of Locally Unresectable or Medically Inoperable pMMR/MSS Non-Metastatic Colon Cancer

This protocol addresses patients with colon adenocarcinoma that is non-metastatic but locally unresectable or medically inoperable. Tumour testing shows proficient mismatch repair (pMMR) and microsatellite stable (MSS) status — a distinct molecular subgroup that shapes the treatment path.

Management in this setting pivots on whether the tumour can be converted to resectable. When conversion is achieved, surgical resection becomes the central intervention, potentially combined with intraoperative radiation. When conversion is not possible, the strategy shifts to a systemic approach.

The complete regimen sequence, agent selection criteria, and full adjuvant options are detailed in the structured protocol.