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KEYNOTE-177 MSI-H mCRC — SCE Medical Oncology MCQ

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ModerateGI CancersKEYNOTE-177 MSI-H mCRCSCE Medical Oncology

A 62-year-old man with CRC has the tumour tested for microsatellite instability. It is MSI-H. In the first-line METASTATIC setting, what does the KEYNOTE-177 trial show?

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Correct answer: A — Pembrolizumab monotherapy is superior to standard chemotherapy as first-line for MSI-H/dMMR mCRC (KEYNOTE-177: PFS 16.5 vs 8.2 months; durable responses; better QoL)

KEYNOTE-177: first-line pembrolizumab vs chemotherapy in MSI-H/dMMR mCRC showed PFS 16.5 vs 8.2 months, ORR 44% vs 33%, complete response 11% vs 4%, and significantly better QoL. Pembrolizumab is now standard first-line for MSI-H mCRC.

Reference: NICE; KEYNOTE-177 André et al NEJM 2020; ESMO 2024 mCRC