MSI (miscrosatellite instability) high and MMRd (mismatch repair-deficient) cancer has turned into something of a battleground between Merck and Bristol Myers Squibb. In the absence of OS data, another key factor in Keytruda’s favour is safety: grade 3 or higher treatment-related adverse events were seen in only 22% of Keytruda subjects, versus 66% in those on chemo control. Keynote-177 will continue to final analysis, at which point OS will be evaluated. Another peculiar feature of the PFS curves is that they cross over early on, suggesting that disease in some Keytruda patients initially progresses faster than with chemo, though this could be down to pseudoprogression. This bold statement is backed up by the fact that an astonishing 40% of Keytruda recipients appear still to be free of disease at over 40 months. some patients were cured of metastatic disease.” “In the past no medical treatment has shown such a difference in terms of improvement of PFS in metastatic colorectal cancer. “The study met one of the two primary endpoints, and is definitively a positive trial,” Dr André told an Asco press briefing. ![]() Indeed, the widening PFS curves with time shows that there likely have not been enough deaths to derive much meaning from an OS analysis. However, nothing has been revealed about Keytruda’s effect on Keynote-177’s second co-primary measure, OS, presumably because the data are insufficiently mature. Accordingly, the reduction in risk of progression across all subjects was 40% (p=0.0002), said Keynote-177’s lead author, Dr Thierry André of Hôpital Saint Antoine in Paris. Importantly, some subjects derived an especially strong PFS benefit, resulting in continued separation of the survival curves after the median was reached.
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