New Data Support De-escalating Chemotherapy in Colorectal Cancer

This transcript has been edited for clarity.

I'm David Kerr, professor of cancer medicine at University of Oxford in England. It's come to that time of year when we consider what we've learned from the American Society for Clinical Oncology (ASCO) annual meeting. In terms of colorectal cancer news, there wasn't a huge amount of new practice-changing information that came out. We know that for any tumor type, information waxes and wanes. And this was a rather lean year.

I picked up on one or two interesting studies. KEYNOTE-177 reaffirmed what we knew when comparing pembrolizumab vs chemotherapy in frontline treatment for patients who've got mismatch repair–deficient colorectal cancer: The treatment of choice is pembrolizumab.

This was a much-touted final report of the overall survival benefits, which weren't seen because a significant number of the patients who had received chemotherapy crossed over, at some stage during their patient journey, to an immune checkpoint inhibitor. Of course, that obfuscated any overall survival benefit, But every other element of clinical activity that we look at, including safety, hugely favors pembrolizumab. So it was a reaffirmation, if you like, of the importance of the immune checkpoint inhibitors as first-line treatment in this setting.