Small bowel adenocarcinoma

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Section editor
Travis Zack, MD, PhD
University of California San Francisco
San Francisco, CA, USA

1 regimens on this page
1 variants on this page


Given the rapid change in evidence in many areas of hematology/oncology, readers are encouraged to consider any guideline published 5+ years ago to be for historical purposes, only.

French Intergroup


Subsequent lines of therapy

Pembrolizumab monotherapy


FDA-recommended dose
Study Dates of enrollment Evidence
Marabelle et al. 2019 (KEYNOTE-158) 2016-2018 Phase 2 (RT)

Note: 7.4% of patients enrolled in KEYNOTE-158 cohort K had small intestine cancer.

Biomarker eligibility criteria

  • MSI-H or dMMR


21-day cycle for up to 35 cycles (2 years)


  1. KEYNOTE-158: Marabelle A, Le DT, Ascierto PA, Di Giacomo AM, De Jesus-Acosta A, Delord JP, Geva R, Gottfried M, Penel N, Hansen AR, Piha-Paul SA, Doi T, Gao B, Chung HC, Lopez-Martin J, Bang YJ, Frommer RS, Shah M, Ghori R, Joe AK, Pruitt SK, Diaz LA Jr. Efficacy of Pembrolizumab in Patients With Noncolorectal High Microsatellite Instability/Mismatch Repair-Deficient Cancer: Results From the Phase II KEYNOTE-158 Study. J Clin Oncol. 2020 Jan 1;38(1):1-10. Epub 2019 Nov 4. link to original article link to PMC article contains dosing details in manuscript PubMed NCT02628067
    1. Update: Maio M, Ascierto PA, Manzyuk L, Motola-Kuba D, Penel N, Cassier PA, Bariani GM, De Jesus Acosta A, Doi T, Longo F, Miller WH, Oh DY, Gottfried M, Xu L, Jin F, Norwood K, Marabelle A. Pembrolizumab in microsatellite instability high or mismatch repair deficient cancers: updated analysis from the phase II KEYNOTE-158 study. Ann Oncol. 2022 Sep;33(9):929-938. Epub 2022 Jun 6. link to original article PubMed