Abstract 112P
Background
Mismatch repair deficient (dMMR) colorectal cancer (CRC) is a subtype of colorectal cancer characterized by the loss of DNA mismatch repair proteins, leading to high microsatellite instability. This subtype presents unique challenges in treatments, often showing resistance to conventional chemotherapy. Pembrolizumab, an immune checkpoint inhibitor, has demonstrated potential efficacy in treating dMMR CRC. This study seeks to compare the effectiveness and safety of pembrolizumab versus standard chemotherapy in patients with dMMR CRC, aiming to provide a comprehensive understanding of treatment results and guide clinical practices.
Methods
Data was collected from Pubmed, ScienceDirect, Google Scholar, and PMC using MeSH keywords “Colorectal Cancer”, “Pembrolizumab” and “Chemotherapy” on June 26th, 2024. Exclusion criterias were incomplete outcome reporting, animal studies, and studies that are irrelevant and irretrievable. The inclusion criterias were patients with mismatch repair deficient (dMMR) colorectal cancer, randomized control trials (RCT), and studies within 5 years that used pembrolizumab or chemotherapy as intervention. All studies measured the progression free survival and hazard ratio which were later then assessed using the JADAD scale to validate the quality of the studies.
Results
Five RCTs out of twelve eligible ones were included which involves 1,444 patients diagnosed with dna mismatch repair deficient colorectal cancer. Meta-analysis demonstrated that the use of pembrolizumab provides a more beneficiary result in comparison to the groups that use chemotherapy with hazard ratio of 0.63 [0.55, 0.72], IV, Fixed, 95% CI . The result suggests that pembrolizumab has a longer progression free survival, lower hazard ratio and fewer adverse events in treating patients with mismatch repair deficient colorectal cancer.
Conclusions
In conclusion, pembrolizumab provides a better treatment option for patients with mismatch repair deficient colorectal cancer, posing a longer progression-free survival, lower hazard ratio, and fewer adverse effects in comparison to chemotherapy.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.