The KEYNOTE-177 trial, renowned in the medical community, delves into the comparison between pembrolizumab and chemotherapy as the first-line treatment for patients with MSI-H/dMMR metastatic colorectal cancer (mCRC). Gastrointestinal oncologists Prof Dekervel from UZ Leuven and Dr Carrasco from Grand Hôpital de Charleroi discuss the extensive follow-up data presented at ESMO 2023.
The primary objective of the KEYNOTE-177 trial was to explore the efficacy of immunotherapy as a first-line treatment. Previous findings have unequivocally demonstrated a substantial advantage in terms of progression-free survival (PFS). The more extended follow-up period will ascertain whether there is also a discernible benefit in Overall Survival (OS).
The data presented here, after 5 years of follow-up, corroborate prior reports. The trend suggests an increase in OS within the pembrolizumab group, although the difference, while clinically noteworthy, did not achieve statistical significance.
A particularly crucial discovery lies in the disparity in response duration between the two arms of the trial. The treatment group exhibited an impressive median response duration of 75 months, in stark contrast to the 10 months observed in the chemotherapy arm. This implies that patients responding to this treatment experience a remarkably prolonged response, spanning several years. The extended response duration raises the possibility of potential cures for this subgroup of mCRC patients.
Reference:
Shiu K.-K. – Pembrolizumab versus chemotherapy in microsatellite instability-high (MSI-H)/mismatch repair-deficient (dMMR) metastatic colorectal cancer (mCRC): 5-year follow-up of the randomized phase 3 KEYNOTE-177 study. ESMO2023 – LBA32
With the educational support of:
 |
 |