ReviewCancer medicine2026
The Keynote-177 Randomized Controlled Trial of First-line PD-1 Blockade for Microsatellite-High or Mismatch Repair-Deficient Advanced Colorectal Cancer: Potential Consequences of the Cross-Over Trial Design and Related Issues.
Review in Cancer medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Some new oncology drugs offer substantial patient health benefit. However, due to high costs, many remain unavailable to patients in low- and middle-income countries. Next to exorbitant drug pricing, uncertainty of the magnitude of benefit of new treatments can contribute to differences in global access to cancer treatments, even in high-income countries. Health technology assessment (HTA) organizations employ predetermined criteria to assess whether a drug's efficacy suffices for local approval, ideally informed by randomized controlled trials (RCTs) that provide data on the clinically relevant endpoints overall survival (OS) and quality of life (QoL). Contemporary oncology RCTs increasingly suffer from design and interpretation issues that lead to inadequate data for HTA assessments. The Keynote-177 RCT was the landmark study demonstrating the superiority of pembrolizumab over chemotherapy in terms of progression free survival and subsequently OS, as a first-line treatment for patients with metastatic microsatellite instable high (MSI) colorectal cancer (CRC). However, in a trial testing the initial efficacy of immunotherapy in advanced MSI CRC, the allowance of crossover delayed the OS signal. Along with other design-related limitations, this complicates the precise determination of the absolute benefit of first-line immunotherapy on OS or quality of life in advanced MSI CRC.
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