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OncoMatch/Clinical Trials/NCT05197322

NEOadjuvant PembRolizumab In Stratified Medicine - ColoRectal Cancer

Is NCT05197322 recruiting? Yes, currently enrolling (May 2026). This Phase 2 trial studies Pembrolizumab for adenocarcinoma of the colon.

Phase 2RecruitingUniversity College, LondonNCT05197322Data as of May 2026

Treatment: PembrolizumabColorectal cancer (CRC) is the 2nd to 3rd most common malignant disease in developed countries, with over 1 million new cases and 500,000 deaths worldwide each year. The primary treatment for early stage CRC is surgery to remove the tumour, which is possible in 80% of patients. Even after surgery up to half of patients will develop recurrence or spread of the disease (metastases) which is incurable. Survival after 5 years is approximately 14% for patients with metastatic disease. Clinical trials using immunotherapy drugs called 'immune checkpoint inhibitors' have shown excellent results in advanced colorectal cancer patients who have certain genetic characteristics called 'mismatch repair deficiency (MMR-d)' and 'high microsatellite instability (MSI-h)'. The benefits of immunotherapy as a treatment prior to surgery to remove the tumour (neoadjuvant treatment) has been observed in both melanoma and in glioblastoma with enhanced local and systemic anti-tumour responses. Pembrolizumab is an immunotherapy drug and works by helping the body's own immune system to fight the cancer cells. The NEOPRISM-CRC trial will investigate whether giving pembrolizumab before surgery is safe, whether it improves the chances of the tumour being removed completely and whether it delays or prevents the cancer from coming back. Pembrolizumab treatment lasts for a maximum of 9 weeks (maximum of 3 cycles of treatment, each cycle consisting of 3 weeks) and is given prior to surgery. Following surgery patients will be followed up for at least 3 years after their surgery and to a maximum of 5 years. Target recruitment is 78 patients and recruitment is expected to take place over a 42 month period. Blood, tissue, mouth swabs and stool samples will be collected from patients throughout the trial to better understand the biology of immunotherapy as a treatment for CRC prior to surgery.

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Extracted eligibility criteria

Cancer type

Colorectal Cancer

Biomarker criteria

Required: MMR deficient by IHC

MMR-d by IHC

Required: MSI high by PCR or microsatellite testing

MSI-H by PCR (or microsatellite testing if routine practice)

Disease stage

Required: Stage RADIOLOGICAL NODE POSITIVE T1-4, NODE NEGATIVE HIGH RISK T3, NODE NEGATIVE T4

Radiological node positive T1-4 CRC or Node negative high risk T3 defined as EITHER ≥ 5mm of extramural depth of invasion OR unequivocal EMVI on imaging (regardless of depth) or Node negative T4 disease

Performance status

ECOG 0–1(Restricted strenuous activity)

Prior therapy

No prior treatment (treatment-naive required)
Max 0 prior lines

Cannot have received: anti-PD-1 therapy

Prior therapy with an anti-PD-1, anti-PD-L1 or anti-PD-L2 agent

Cannot have received: checkpoint inhibitor

agent directed to another stimulatory or co-inhibitory T-cell receptor (e.g. CTLA-4, OX-40, CD137)

Cannot have received: systemic anti-cancer therapy

Prior systemic anti-cancer therapy including investigational agents within 4 weeks prior to registration

Lab requirements

Blood counts

White Blood Cell >3.0 x 10^9/L; Absolute neutrophil count ≥1.5 x 10^9/L; Platelets ≥100 x 10^9/L; Haemoglobin ≥90 g/L

Kidney function

GFR >50 mL/min estimated using validated creatinine clearance calculation (e.g. Cockroft-Gault); if calculated CrCl < 50 mL/min, formal 24 hour urine collection or isotope clearance must demonstrate GFR ≥ 50 mL/min

Liver function

Total bilirubin < 1.5x ULN OR direct bilirubin ≤ULN for participants with total bilirubin >1.5 × ULN; AST and ALT ≤ 2.5 × ULN

Adequate bone marrow function: White Blood Cell >3.0 x 10^9/L; Absolute neutrophil count ≥1.5 x 10^9/L; Platelets ≥100 x 10^9/L. Haemoglobin ≥90 g/L. Adequate renal function: GFR >50 mL/min... Adequate liver function: Total bilirubin < 1.5x ULN OR direct bilirubin ≤ULN for participants with total bilirubin >1.5 × ULN; AST and ALT ≤ 2.5 × ULN

Structured fields extracted by AI. May contain errors — verify against the official protocol.

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