Une phase II randomisée est ouverte pour les cancers rares de phénotype MSI : Pan-MSI-AcSé

Le résumé fourni par la source

Immune checkpoint inhibitors have revolutionised the management of patients with metastatic colorectal or endometrial cancer with the MSI/dMMR phenotype from the first line of treatment. The MSI phenotype is a major predictive marker of response to immune checkpoint inhibitors. Three non-randomised phase II trials have evaluated the efficacy of pembrolizumab or dostarlimab across several tumour types in patients with progressive disease on standard therapy, with significant efficacy in terms of response rate and progression-free survival. The current challenge concerns patients with advanced cancers whose primary tumour has an MSI/dMMR phenotype other than colorectal or endometrial. In most cases, these patients are not screened for their MSI/dMMR status, and we strongly recommend that this be done. These patients often lack approved therapeutic alternatives beyond chemotherapy, which remains the standard of care in these situations, with a median PFS of six months, regardless of the primary tumour site. In 2024, two initial phase II clinical trials began under the new French AcSé programme, one of which focuses on MSI/dMMR tumours, the subject of this article. The randomised phase II Pan-MSI-AcSé trial is evaluating patients with advanced disease from various primary tumour sites, treated either with dostarlimab (experimental arm A) or chemotherapy (control arm B) according to standard of care (SOC), with the possibility of cross-over with dostarlimab in the standard arm. The study aims to include 120 patients, and this article seeks to introduce the study and encourage patient enrolment.

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