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Pre-Surgery Pembrolizumab Shows Zero Relapses in MSI-High Bowel Cancer Trial

The small UCL-led study signals a possible way to spare many patients chemotherapy pending confirmation in larger trials.

Overview

  • The NEOPRISM-CRC team reported at the AACR meeting in April that none of the 32 treated patients relapsed after about 33 months.
  • Patients with stage 2 or 3 MMR-deficient or MSI-high tumors received up to nine weeks of pembrolizumab before surgery instead of the usual surgery followed by months of chemotherapy.
  • Fifty-nine percent had no sign of disease after the short immunotherapy course plus surgery, and small amounts of residual cancer in others did not progress on follow-up.
  • Personalized blood tests that track tumor DNA and immune profiling helped identify likely responders, offering a path to tailor how much treatment each patient needs.
  • Researchers note the cohort is small and non-randomized in a defined genetic subgroup, so larger controlled studies are needed before changing standard care.