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Pembrolizumab as first-line in MSI-H mCRC

The first phase 3 study of pembrolizumab versus standard-of-care (i.e. chemotherapy + bevacizumab or cetuximab) demonstrated superiority for first-line pembrolizumab in patients with high microsatellite instability (MSI-H) metastatic colorectal cancer (mCRC), reported Prof. Thierry André (St Antoine Hospital, France) [1].

About 5% of all mCRC are characterised by MSI-H, often linked with germline mutations in Lynch Syndrome. Mismatch repair status and MSI-H predict clinical benefit of immune checkpoint blockade with pembrolizumab as first-line therapy for MSI-H mCRC and has been FDA approved for adults and children with metastatic tumours with MSI, regardless of the tumour type. Previously, KEYNOTE-164 evaluated the anti-tumour activity of pembrolizumab in previously treated, metastatic, microsatellite instability-high/mismatch repair-deficient (MSI-H/dMMR) colorectal cancer (CRC) [2]. In the current...

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