Mismatch repair deficiency, chemotherapy and survival for resectable gastric cancer: an observational study from the German staR cohort and a meta-analysis.
Chemotherapy
Gastric cancer
Meta-analysis
Mismatch repair deficiency
Survival
Journal
Journal of cancer research and clinical oncology
ISSN: 1432-1335
Titre abrégé: J Cancer Res Clin Oncol
Pays: Germany
ID NLM: 7902060
Informations de publication
Date de publication:
Mar 2023
Mar 2023
Historique:
received:
21
12
2021
accepted:
08
02
2022
pubmed:
26
2
2022
medline:
8
3
2023
entrez:
25
2
2022
Statut:
ppublish
Résumé
In a post hoc analysis of the MAGIC trial, patients with curatively resected gastric cancer (GC) and mismatch repair (MMR) deficiency (MMRd) had better median overall survival (OS) when treated with surgery alone but worse median OS when treated with additional chemotherapy. Further data are required to corroborate these findings. Between April 2013 and December 2018, 458 patients with curatively resected GC, including cancers of the esophagogastric junction Siewert type II and III, were identified in the German centers of the staR consortium. Tumor sections were assessed for expression of MLH1, MSH2, MSH6 and PMS2 by immunohistochemistry. The association between MMR status and survival was assessed. Similar studies published up to January 2021 were then identified in a MEDLINE search for a meta-analysis. MMR-status and survival data were available for 223 patients (median age 66 years, 62.8% male), 23 patients were MMRd (10.3%). After matching for baseline clinical characteristics, median OS was not reached in any subgroup. Compared to perioperative chemotherapy, patients receiving surgery alone with MMRd and MMRp had a HR of 0.67 (95% CI 0.13-3.37, P = 0.63) and 1.44 (95% CI 0.66-3.13, P = 0.36), respectively. The meta-analysis included pooled data from 385 patients. Compared to perioperative chemotherapy, patients receiving surgery alone with MMRd had an improved OS with a HR of 0.36 (95% CI 0.14-0.91, P = 0.03), whereas those with MMRp had a HR of 1.18 (95% CI 0.89-1.58, P = 0.26). Our data support a positive prognostic effect for MMRd in GC patients treated with surgery only and a differentially negative prognostic effect in patients treated with perioperative chemotherapy. MMR status determined by preoperative biopsies may be used as a predictive biomarker to select patients for perioperative chemotherapy in curatively resectable GC.
Identifiants
pubmed: 35211781
doi: 10.1007/s00432-022-03953-y
pii: 10.1007/s00432-022-03953-y
pmc: PMC9984318
doi:
Substances chimiques
MutL Protein Homolog 1
EC 3.6.1.3
Types de publication
Meta-Analysis
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1007-1017Informations de copyright
© 2022. The Author(s).
Références
Bull Cancer. 2020 Apr;107(4):438-446
pubmed: 32057467
Am J Surg Pathol. 2016 Apr;40(4):e17-34
pubmed: 26974895
Virchows Arch. 2006 Mar;448(3):344-53
pubmed: 16261379
Nature. 2014 Sep 11;513(7517):202-9
pubmed: 25079317
Bull Cancer. 2019 Feb;106(2):119-128
pubmed: 30713006
Ann Oncol. 2020 Oct;31(10):1291-1305
pubmed: 32702383
J Gastrointestin Liver Dis. 2021 Dec 21;30(4):431-437
pubmed: 34752588
J Clin Oncol. 2021 Feb 20;39(6):642-651
pubmed: 33356421
N Engl J Med. 2006 Jul 6;355(1):11-20
pubmed: 16822992
CA Cancer J Clin. 2018 Nov;68(6):394-424
pubmed: 30207593
Clin Cancer Res. 2020 Jul 15;26(14):3784-3790
pubmed: 32156744
Eur J Pharmacol. 2014 Oct 5;740:364-78
pubmed: 25058905
Ann Oncol. 2016 Sep;27(suppl 5):v38-v49
pubmed: 27664260
Mol Cell Biochem. 2016 Jan;412(1-2):297-305
pubmed: 26728996
World J Surg. 2012 Sep;36(9):2131-8
pubmed: 22669398
N Engl J Med. 2020 Dec 3;383(23):2207-2218
pubmed: 33264544
Z Gastroenterol. 2019 Dec;57(12):1517-1632
pubmed: 31826284
Helicobacter. 2016 Sep;21 Suppl 1:39-44
pubmed: 27531538
Arch Toxicol. 2015 Jun;89(6):899-921
pubmed: 25701956
Cancer Treat Rev. 2020 Jun;86:102024
pubmed: 32388292
JCO Precis Oncol. 2017;2017:
pubmed: 29850653
Acta Pathol Microbiol Scand. 1965;64:31-49
pubmed: 14320675
Mutat Res Rev Mutat Res. 2017 Jul;773:174-187
pubmed: 28927527
Trials. 2007 Jun 07;8:16
pubmed: 17555582
Ann Surg Oncol. 2016 Mar;23(3):943-50
pubmed: 26530444
J Clin Oncol. 2019 Dec 10;37(35):3392-3400
pubmed: 31513484
Clin Cancer Res. 2014 Jun 1;20(11):2831-7
pubmed: 24879823
Br J Surg. 2018 Feb;105(3):159-167
pubmed: 29091259
Int J Clin Exp Pathol. 2018 May 01;11(5):2579-2587
pubmed: 31938371
Best Pract Res Clin Gastroenterol. 2006;20(4):633-49
pubmed: 16997150
J Clin Oncol. 2020 Jan 1;38(1):1-10
pubmed: 31682550
Eur J Surg Oncol. 2020 Jan;46(1):189-194
pubmed: 31500870
JAMA Oncol. 2017 Sep 01;3(9):1197-1203
pubmed: 28241187
Gastroenterology. 2010 Feb;138(2):487-92
pubmed: 19900449
United European Gastroenterol J. 2020 Mar;8(2):175-184
pubmed: 32213076
J Pathol Clin Res. 2019 Oct;5(4):227-239
pubmed: 31206244
Gastric Cancer. 2017 Jan;20(1):156-163
pubmed: 26796888
Mod Pathol. 2003 Jul;16(7):641-51
pubmed: 12861059
Gastric Cancer. 2019 Jul;22(4):785-792
pubmed: 30617648
JAMA. 2010 May 5;303(17):1729-37
pubmed: 20442389
DNA Repair (Amst). 2016 Feb;38:94-101
pubmed: 26704428
J Immunother Cancer. 2019 Jan 31;7(1):24
pubmed: 30704511