Survival of patients with deficient mismatch repair metastatic colorectal cancer in the pre-immunotherapy era

被引:21
作者
Wensink, G. Emerens [1 ]
Elferink, Marloes A. G. [2 ]
May, Anne M. [3 ]
Mol, Linda [2 ]
Hamers, Patricia A. H. [1 ]
Bakker, Sandra D. [4 ]
Creemers, Geert-Jan [5 ]
de Groot, Jan Willem B. [6 ]
de Klerk, Gerty J. [7 ]
Haberkorn, Brigitte C. M. [8 ]
Haringhuizen, Annebeth W. [9 ]
Hoekstra, Ronald [10 ]
Hunting, J. Cornelis B. [11 ]
Kerver, Emile D. [12 ]
Mathijssen-van Stein, Danielle [13 ]
Polee, Marco B. [14 ]
Pruijt, Johannes F. M. [15 ]
Quarles van Ufford-Mannesse, Patricia [16 ]
Radema, Sandra [17 ]
Rietbroek, Ronald C. [18 ]
Simkens, Lieke H. J. [19 ]
Tanis, Bea C. [20 ]
ten Bokkel Huinink, Daan [21 ]
Tjin-A-Ton, Manuel L. R. [22 ]
Tromp-van Driel, Cathrien S. [23 ]
Troost, Monique M. [24 ]
van de Wouw, Agnes J. [25 ]
van den Berkmortel, Franchette W. P. J. [26 ]
van der Pas, Anke J. M. [27 ]
van der Velden, Ankie M. T. [28 ]
van Dijk, Marjan A. [29 ]
van Dodewaard-de Jong, Joyce M. [30 ]
van Druten, Edith B. [31 ]
van Voorthuizen, Theo [32 ]
Jan Veldhuis, Gerrit [33 ]
Verheul, Henk M. W. [34 ]
Vestjens, Hanneke J. H. M. J. [25 ]
Vincent, Jeroen [35 ]
Kranenburg, Onno W. [36 ,37 ]
Punt, Cornelis J. A. [38 ]
Vink, Geraldine R. [1 ,2 ]
Roodhart, Jeanine M. L. [1 ]
Koopman, Miriam [1 ]
机构
[1] Univ Utrecht, Univ Med Ctr Utrecht, Dept Med Oncol, Univ Weg 100, NL-3584 CG Utrecht, Netherlands
[2] Netherlands Comprehens Canc Org, Dept Res, Postbus 19079, NL-3501 DB Utrecht, Netherlands
[3] Univ Utrecht, Univ Med Ctr Utrecht, Julius Ctr Hlth Sci & Primary Care, POB 85500, NL-3508 GA Utrecht, Netherlands
[4] Zaans Med Ctr, Dept Med Onco, Postbus 210, NL-1500 EE Zaandam, Netherlands
[5] Catharina Hosp, Dept Med Oncol, Postbus 1350, NL-5602 ZA Eindhoven, Netherlands
[6] Isala Hosp, Dept Med Oncol, Dokter Heesweg 2, NL-8025 AB Zwolle, Netherlands
[7] Spaarne Gasthuis, Dept Med Oncol, Spaarnepoort 1, NL-2134 TM Hoofddorp, Netherlands
[8] Maasstad Hosp, Dept Med Oncol, Postbus 9100, NL-3007 AC Rotterdam, Netherlands
[9] Hosp Gelderse Vallei, Dept Med Oncol, Willy Brandtlaan 10, NL-6716 RP Ede, Netherlands
[10] Ziekenhuisgroep Twente, Dept Med Oncol, Postbus 7600, NL-7600 SZ Almelo, Netherlands
[11] Antonius Hosp, Dept Med Oncol, Postbus 2500, NL-3430 EM Nieuwegein, Netherlands
[12] OLVG, Dept Med Oncol, Oosterpark 9, NL-1091 AC Amsterdam, Netherlands
[13] Franciscus Gasthuis & Vlietland, Dept Med Oncol, Vlietlandpl, NL-3118 JH Schiedam, Netherlands
[14] Med Ctr Leeuwarden, Dept Med Oncol, Postbus 888, NL-8901 BR Leeuwarden, Netherlands
[15] Jeroen Bosch Hosp, Dept Med Oncol, Postbus 90153, NL-5200 ME Shertogenbosch, Netherlands
[16] HagaZiekenhuis, Dept Med Oncol, Els Borst Eilerspl 275, NL-2545 AA The Hague, Netherlands
[17] Radboud Univ Nijmegen, Dept Med Oncol, Med Ctr, Postbus 9101, NL-6500 HB Nijmegen, Netherlands
[18] Rode Kruis Hosp, Dept Med Oncol, Postbus 1074, NL-1940 EB Beverwijk, Netherlands
[19] Maxima Med Ctr, Dept Med Oncol, Postbus 90052, NL-5600 PD Eindhoven, Netherlands
[20] Groene Hart Hosp, Dept Med Oncol, Bleulandweg 10, NL-2803 HH Gouda, Netherlands
[21] Diakonessenhuis Utrecht, Dept Med Oncol, Postbus 80250, NL-3508 TG Utrecht, Netherlands
[22] Hosp Rivierenland, Dept Med Oncol, President Kennedylaan 1, NL-4002 WP Tiel, Netherlands
[23] Gelre Hosp, Dept Med Oncol, Postbus 9014, NL-7300 DS Apeldoorn, Netherlands
[24] Bravis Hosp Bergen Zoom, Dept Med Oncol, Postbus 999, NL-4700 AZ Roosendaal, Netherlands
[25] VieCuri Med Ctr, Dept Med Oncol, Postbus 1926, NL-5900 BX Venlo, Netherlands
[26] Zuyderland Med Ctr Heerlen, Dept Med Oncol, Postbus 5500, NL-6130 MB Geleen, Netherlands
[27] LangeLand Hosp, Dept Med Oncol, Postbus 3015, NL-2700 KJ Zoetermeer, Netherlands
[28] Tergooi, Dept Med Oncol, Riebeeckweg 212, NL-1213 XZ Hilversum, Netherlands
[29] ZorgSaam Hosp, Dept Med Oncol, Wielingenlaan 2, NL-4535 PA Terneuzen, Netherlands
[30] Meander Med Ctr, Dept Med Oncol, Postbus 1502, NL-3800 BM Amersfoort, Netherlands
[31] Reinier Graaf Gasthuis, Dept Med Oncol, Postbus 5011, NL-2600 GA Delft, Netherlands
[32] Hosp Rijnstate, Dept Med Oncol, Wagnerlaan 55, NL-6815 AD Arnhem, Netherlands
[33] Antonius Hosp Sneek, Dept Med Oncol, Postbus 20000, NL-8600 BA Sneek, Netherlands
[34] Univ Amsterdam, Med Ctr, Dept Med Oncol, Box 7057, NL-1007 MB Amsterdam, Netherlands
[35] Elkerliek Hosp, Dept Med Oncol, Postbus 98, NL-5700 AB Helmond, Netherlands
[36] Univ Utrecht, Univ Med Ctr Utrecht, Dept Surg Oncol, Postbus 98, NL-5700 AB Utrecht, Netherlands
[37] Univ Utrecht, Univ Med Ctr Utrecht, Utrecht Platform Organoid Technol, Postbus 98, NL-5700 AB Utrecht, Netherlands
[38] Univ Amsterdam, Med Centers, Dept Med Oncol, Postbus 22660, Amsterdam, Netherlands
关键词
MICROSATELLITE INSTABILITY; POOLED ANALYSIS; BRAF MUTATION; PHASE-III; CAPECITABINE; OXALIPLATIN; MULTICENTER; BEVACIZUMAB; NIVOLUMAB; PROGNOSIS;
D O I
10.1038/s41416-020-01076-0
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
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.
引用
收藏
页码:399 / 406
页数:8
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