Earlier this month, Pharmac called for feeback on their proposal to widen access to Pembrolizumab to treat microsatellite instability-high or deficient mismatch repair (MSI-H/dMMR) colorectal cancer.
We and the community we represent welcome the proposal. For a patient group with limited treatment options, access to this treatment will be a game changer and something we are delighted to see.
In response to the call for feedback on the proposal, we note that Checkmate 142 and Keynote 164 tested PD1i monotherapy in patients with previously treated dMMR colorectal cancer. While response rates in this population are lower than when used in first line, they are still >30%, compared to 4% with second line irinotecan-based therapy (Tournigand et al).
We support the indication for first line therapy, however, consider that the relatively small number of patients who currently have metastatic dMMR colorectal cancer and have received prior treatment with chemotherapy should be included to receive immunotherapy too.
We will keep you updated with developments on the progress of the widening of access to Pembrolizumab for this group of colorectal cancer patients.