1. Survival of patients with deficient mismatch repair metastatic colorectal cancer in the pre-immunotherapy era.
- Author
-
Wensink GE, Elferink MAG, May AM, Mol L, Hamers PAH, Bakker SD, Creemers GJ, de Groot JWB, de Klerk GJ, Haberkorn BCM, Haringhuizen AW, Hoekstra R, Hunting JCB, Kerver ED, Mathijssen-van Stein D, Polée MB, Pruijt JFM, Quarles van Ufford-Mannesse P, Radema S, Rietbroek RC, Simkens LHJ, Tanis BC, Ten Bokkel Huinink D, Tjin-A-Ton MLR, Tromp-van Driel CS, Troost MM, van de Wouw AJ, van den Berkmortel FWPJ, van der Pas AJM, van der Velden AMT, van Dijk MA, van Dodewaard-de Jong JM, van Druten EB, van Voorthuizen T, Jan Veldhuis G, Verheul HMW, Vestjens HJHMJ, Vincent J, Kranenburg OW, Punt CJA, Vink GR, Roodhart JML, and Koopman M
- Subjects
- Adult, Aged, Colorectal Neoplasms mortality, DNA Mismatch Repair, Female, Humans, Male, Middle Aged, Survival Analysis, Antineoplastic Agents therapeutic use, Colorectal Neoplasms drug therapy, Colorectal Neoplasms genetics, Microsatellite Instability
- Abstract
Background: Metastatic colorectal cancer patients with deficient mismatch repair (dMMR mCRC) benefit from immunotherapy. Interpretation of the single-arm immunotherapy trials is complicated by insignificant survival data during systemic non-immunotherapy. We present survival data on a large, comprehensive cohort of dMMR mCRC patients, treated with or without systemic non-immunotherapy., Methods: Two hundred and eighty-one dMMR mCRC patients (n = 54 from three prospective Phase 3 CAIRO trials; n = 227 from the Netherlands Cancer Registry). Overall survival was analysed from diagnosis of mCRC (OS), from initiation of first-line (OS1) and second-line (OS2) systemic treatment. Cox regression analysis examined prognostic factors. As comparison for OS 2746 MMR proficient mCRC patients were identified., Results: Of 281 dMMR patients, 62% received first-line and 26% second-line treatment. Median OS was 16.0 months (13.8-19.6) with antitumour therapy and 2.5 months (1.8-3.5) in untreated patients. OS1 was 12.8 months (10.7-15.2) and OS2 6.2 months (5.4-8.9) in treated dMMR patients. Treated dMMR patients had a 7.6-month shorter median OS than pMMR patients., Conclusion: Available data from immunotherapy trials lack a control arm with standard systemic treatment. Given the poor outcome compared to the immunotherapy results, our data strongly suggest a survival benefit of immunotherapy in dMMR mCRC patients.
- Published
- 2021
- Full Text
- View/download PDF