![]() Pembrolizumab also significantly prolonged the time to deterioration in physical functioning, social functioning, and fatigue, he added. In many domains, scores continued to improve out to week 45 for patients receiving pembrolizumab, but worsened over time in those treated with chemotherapy. The domains showing the largest differences between the treatments, favoring pembrolizumab, were physical function, role function, social function, fatigue, pain, and appetite loss. “From baseline to week 18, patients on pembrolizumab generally exhibited stable or improved scores in most of the QLQ-C30 domains and improved scores in most of the symptom domains, whereas patients in the chemotherapy arm generally exhibited worsening scores for all except the emotional function domain,” he said. In the Colo-rectal cancer EQ-5D scale, scores also improved with pembrolizumab and worsened with chemotherapy,” Dr. Least squares mean (LSM) change from baseline to week 18 showed improvement in QLQ-C30 GHS/QoL with pembrolizumab versus chemotherapy (LSM difference: 8.96 95% CI 4.24 to 13.69 P =. At week 18, the QLQ-C30 improved over baseline in the pembrolizumab arm but worsened in the chemotherapy group. “The EORTC QLQ-C30, GHS/QoL, and EQ-5D visual analog scale scores were similar at baseline between the groups. Scores generally improved in patients receiving pembrolizumab but worsened for those treated with chemotherapy.In the prespecified exploratory analysis of patient-reported outcomes, pembrolizumab was also associated with significantly better health-related quality-of-life scores. ![]() KEYNOTE-177 found that first-line pembrolizumab significantly improved progression-free survival vs chemotherapy in patients with metastatic colorectal cancer with MSI-H/dMMR tumors.Similar compliance was observed for the other quality-of-life instruments. ![]() It was again completed at the prespecified week 18 time point by 88% of the pembrolizumab arm and 77% of the chemotherapy arm and at week 45 by 84% and 56%, respectively. The EORTC QLQ-C30 questionnaire was completed at baseline by 93% of each group. Data were collected at baseline, during treatment, espescially at week 18, and 30 days after treatment discontinuation. Time to deterioration in the EORTC QLQ-C30 was another patient-reported outcome. Altogether, these instruments comprise a variety of functional scales in physical, social, cognitive, and emotional domains, measuring symptoms, mobility, self-care, usual activity, pain and discomfort, anxiety and depression, and some colorectal cancer–specific factors. These parameters included mean score change from baseline to week 18 in the following scales and items: European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30 (QLQ-C30), EORTC QLQ-CR29, and EuroQoL 5 Dimensions 3 Levels (EQ-5D-3L). Patent-reported outcomes constituted a prespecified exploratory endpoint. “The study was considered successful if pembrolizumab was superior to chemotherapy for either primary endpoint,” Dr. 0002), and thus, KEYNOTE-177 met one of its two co-primary endpoints (overall survival will be reported later). Patients receiving pembrolizumab had a median progression-free survival of 16.5 months vs 8.2 months with chemotherapy (hazard ratio = 0.60 P =. The open-label study randomly assigned 307 previously untreated patients to first-line pembrolizumab at 200 mg every 3 weeks for up to 2 years or investigator’s choice of modified FOLFOX6 (fluorouracil, leucovorin, oxaliplatin) or FOLFIRI (5-FU, leucovorin, irinotecan) every 2 weeks, with or without bevacizumab or cetuximab. ![]() André reported in a Plenary Session presented during the ASCO20 Virtual Scientific Program. The phase III KEYNOTE-177 trial showed, for the first time, that upfront treatment with immunotherapy (pembrolizumab) could improve progression-free survival vs chemotherapy as a first-line treatment of microsatellite instability–high (MSI-H)/mismatch repair–deficient (dMMR) metastatic colorectal cancer, Dr. ![]()
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