Pembrolizumab combined with xelox and bevacizumab shows higher efficacy than standard therapeutic regimen in mCRC

Prof David Tougeron - Poitiers University Hospital, Poitiers, France

My POCHI trial is on metastatic colorectal adenocarcinoma. As you probably know, most of the metastatic colorectal adenocarcinomas are not responsive to immune checkpoint inhibitors, and in this trial we evaluated a combination of chemotherapy plus bevacizumab and pembrolizumab in MSS and pMMR colorectal adenocarcinoma with a high immune infiltrate.

What was the study design?

It is a single-arm trial, phase II.

What were the results of the study?

The results of the study show a high rate of response to the combination of XELOX, bevacizumab and pembrolizumab in these patients with metastatic colorectal adenocarcinoma with a high immune infiltrate. We observed a complete response rate of 21%, a disease control rate of 94% and we have a progression free survival at one year of 68%.

What is the clinical significance of these results?

Since it is a small phase II trial and not randomised the implication for clinical routine practice is limited but this result is very good. We hope to start soon a randomised phase III to evaluate it in these patients as a combination of chemotherapy and immune checkpoint inhibitors versus standard of care alone.

What is next for this study?

The next step is a randomised phase III to evaluate this combination of chemotherapy plus bevacizumab and immune checkpoint inhibitors in this subgroup of metastatic colorectal adenocarcinoma with high immune infiltration.