Survival of patients with deficient mismatch repair metastatic colorectal cancer in the pre-immunotherapy era
Wensink, G Emerens; Elferink, Marloes A G; May, Anne M; Mol, Linda; Hamers, Patricia A H; Bakker, Sandra D; Creemers, Geert-Jan; de Groot, Jan Willem B; de Klerk, Gerty J; Haberkorn, Brigitte C M; Haringhuizen, Annebeth W; Hoekstra, Ronald; Hunting, J Cornelis B; Kerver, Emile D; Mathijssen-van Stein, Danielle; Polée, Marco B; Pruijt, Johannes F M; Quarles van Ufford-Mannesse, Patricia; Radema, Sandra; Rietbroek, Ronald C; Simkens, Lieke H J; Tanis, Bea C; Ten Bokkel Huinink, Daan; Tjin-A-Ton, Manuel L R; Tromp-van Driel, Cathrien S; Troost, Monique M; van de Wouw, Agnes J; van den Berkmortel, Franchette W P J; van der Pas, Anke J M; van der Velden, Ankie M T; van Dijk, Marjan A; van Dodewaard-de Jong, Joyce M; van Druten, Edith B; van Voorthuizen, Theo; Jan Veldhuis, Gerrit; Verheul, Henk M W; Vestjens, Hanneke J H M J; Vincent, Jeroen; Kranenburg, Onno W; Punt, Cornelis J A; Vink, Geraldine R; Roodhart, Jeanine M L; Koopman, Miriam
(2021) British Journal of Cancer, volume 124, issue 2, pp. 399 - 406
(Article)
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
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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.
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Keywords: Oncology, Cancer Research, Journal Article
ISSN: 0007-0920
Publisher: Springer Nature
Note: Publisher Copyright: © 2020, The Author(s), under exclusive licence to Cancer Research UK. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
(Peer reviewed)