Pembrolizumab for the treatment of colorectal cancer

Dahna Coupez (1) , Pauline Hulo (2, 1) , Yann Touchefeu (1) , Céline Bossard (3) , Jaafar Bennouna (2, 1)

1 Hôtel Dieu - Institut des Maladies de l’Appareil Digestif et Oncologie Digestive [CHU Nantes]
2 CRCINA-ÉQUIPE 4 - Immunogenic Cell Death and Mesothelioma Therapy
3 Service d’Anatomie et Cytologie Pathologiques [CHU Nantes]

Introduction: Colorectal cancer (CRC) is one of the most frequent and lethal cancers in the world, and therapies are still insufficient. Immune checkpoint inhibitors (ICI) in metastatic CRC (mCRC) have not revolutionized treatment to the extent that they have in melanoma or renal carcinoma. Their use is limited to a molecular niche of mCRC with microsatellite instability (MSI). This review summarizes clinical data published with pembrolizumab in mCRC and also tries to identify potential new strategies. Areas covered: This paper focuses on pembrolizumab in mCRC. We screened all trials on PubMed and ClinicalTrials.gov and describe the most significant ones in our opinion. Expert opinion: Pembrolizumab seems to be effective in tumors with MSI-high status. It defines a new horizon for therapeutic strategy called 'agnostic' medicine. For microsatellite stable (MSS) colorectal cancers, the future challenge will be to successfully redraw the immune microenvironment to make it immunogenic with new therapeutic combinations, including ICI

Mots clés: Colorectal cancer; immune checkpoint inhibitors; pembrolizumab; tumor mutational burden

Domaines: Cancer

Dahna Coupez, Pauline Hulo, Yann Touchefeu, Céline Bossard, Jaafar Bennouna. Pembrolizumab for the treatment of colorectal cancer. Expert Opinion on Biological Therapy, 2020, 20 (3), pp.219-226. ⟨10.1080/14712598.2020.1718095⟩. ⟨inserm-02547539⟩