LBA4 @ASCO #ASCO20 plenary session:
Thierry Andre presents the results of KEYNOTE-177 (Pembro vs. CTX) in MSI/dMMR #crcsm : Doubling of PFS w. Prembro (https://abs.twimg.com/emoji/v2/... draggable="false" alt="1️⃣" title="Keycap digit one" aria-label="Emoji: Keycap digit one">https://abs.twimg.com/emoji/v2/... draggable="false" alt="6️⃣" title="Keycap digit six" aria-label="Emoji: Keycap digit six">.https://abs.twimg.com/emoji/v2/... draggable="false" alt="5️⃣" title="Keycap digit five" aria-label="Emoji: Keycap digit five"> vs https://abs.twimg.com/emoji/v2/... draggable="false" alt="8️⃣" title="Keycap digit eight" aria-label="Emoji: Keycap digit eight">.https://abs.twimg.com/emoji/v2/... draggable="false" alt="5️⃣" title="Keycap digit five" aria-label="Emoji: Keycap digit five"> months - HR 0.60). Median DOR was not reached (https://abs.twimg.com/emoji/v2/... draggable="false" alt="‼️" title="Double exclamation mark" aria-label="Emoji: Double exclamation mark">) in the Pembro group (vs. 10.6 months).
@OncoAlert https://abs.twimg.com/emoji/v2/... draggable="false" alt="🚨" title="Police cars revolving light" aria-label="Emoji: Police cars revolving light">

(1/6) To underscore the effect on the individual, I would like to share the story of one of my pts diagnosed w. #crcsm in the setting of Lynch. Mid 30ies, admitted w. tumour perforation & mets to the liver, lungs & peritoneum requiring emergency surgery.
@OncoAlert https://abs.twimg.com/emoji/v2/... draggable="false" alt="🚨" title="Police cars revolving light" aria-label="Emoji: Police cars revolving light">

(2/6) After recovery, the patients got a slot for KEYNOTE-177 & was randomised to the Pembrolizumab arm. When the patient went on trial, he/she was still weak due to the high tumour burden.
Baseline scans below. @OncoAlert https://abs.twimg.com/emoji/v2/... draggable="false" alt="🚨" title="Police cars revolving light" aria-label="Emoji: Police cars revolving light">

(3/6) Within weeks, tumours shrank & the patients condition improved on an almost daily basis.
Within 6 months, disease burden was significantly reduced.
Based on the excellent systemic response & the scans below, our team decided to explore surgical options.
@OncoAlert https://abs.twimg.com/emoji/v2/... draggable="false" alt="🚨" title="Police cars revolving light" aria-label="Emoji: Police cars revolving light">

(4/6) To this day, I remember my friend from path. calling me asking „what kind of hardcore chemo have you given to the patient?“ Histology showed major regression/necrosis as well as NED at all resection sites (liver & peritoneum - later lung & mediastinum).
@OncoAlert https://abs.twimg.com/emoji/v2/... draggable="false" alt="🚨" title="Police cars revolving light" aria-label="Emoji: Police cars revolving light">

(5/6) As of today, the patient is alive and well and in complete remission and we have stopped Pembrolizumab.
#researchsaveslifes

(6/6) Personal opinion: Being an oncologist practicing GI #oncology & #PrecisionMedicine , I find it hard to accept that Pembrolizumab hasn’t been filed/approved in this indication in https://abs.twimg.com/emoji/v2/... draggable="false" alt="🇪🇺" title="Flag of European Union" aria-label="Emoji: Flag of European Union">Meaning that docs have to file for off label coverage & patients suffer waiting for approval.