Prognostic value of mismatch repair deficiency in patients receiving first-line fluoropyrimidine plus platinum for metastatic, recurrent, or unresectable gastric cancer.

IF 6 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Gastric Cancer Pub Date : 2024-07-01 Epub Date: 2024-03-31 DOI:10.1007/s10120-024-01483-9

Chung Ryul Oh, Eo Jin Kim, Heejung Chae, Young Soo Park, Min-Hee Ryu, Hyung-Don Kim, Yoon-Koo Kang

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Abstract

Background: We examined the impact of mismatch repair (MMR) status on efficacy of first-line fluoropyrimidine plus platinum (FP) chemotherapy in patients with HER2-negative metastatic, recurrent, or unresectable gastric cancer (mGC).

Methods: Patients with mGC receiving first-line FP between 2015 and 2018 at Asan Medical Center, Korea, were reviewed. We evaluated the clinical characteristics and the efficacy of chemotherapy according to MMR status in patients with available immunohistochemistry results.

Results: Of 895 patients, we analyzed 543 with available MMR protein expression results, and deficient MMR (dMMR) was detected in 4.4% (n = 24). Patients with dMMR exhibited a significantly higher median age than those with proficient MMR (pMMR) (64 vs. 58 years, p = 0.044). No signet ring cell carcinoma (SRCC) was detected among dMMR tumors, whereas SRCC was found in 17.5% of pMMR. Objective response rate was 27.3% in dMMR and 34.3% in pMMR (p = 0.556). No difference in progression-free survival was noted between patients with dMMR and pMMR (median, 5.6 vs. 5.8 months, p = 0.266). Patients with dMMR tended to have better overall survival than those with pMMR although this difference was not statistically significant (median, 17.9 vs. 12.2 months, p = 0.183).

Conclusions: Efficacy of first-line FP was not different by MMR status in mGC patients.

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错配修复缺陷对接受一线氟嘧啶加铂治疗的转移性、复发性或不可切除胃癌患者的预后价值。

研究背景我们研究了错配修复（MMR）状态对HER2阴性转移性、复发性或不可切除胃癌（mGC）患者一线氟嘧啶加铂（FP）化疗疗效的影响：对韩国牙山医疗中心2015年至2018年间接受一线FP治疗的mGC患者进行了回顾性研究。我们根据有免疫组化结果的患者的MMR状态评估了其临床特征和化疗疗效：在895名患者中，我们分析了543名有MMR蛋白表达结果的患者，发现4.4%的患者（n = 24）存在MMR缺陷（dMMR）。dMMR 患者的中位年龄明显高于精通 MMR（pMMR）患者（64 岁对 58 岁，p = 0.044）。在dMMR肿瘤中未发现标志环细胞癌（SRCC），而在pMMR中17.5%的肿瘤中发现了SRCC。dMMR和pMMR的客观反应率分别为27.3%和34.3%（P = 0.556）。dMMR 和 pMMR 患者的无进展生存期没有差异（中位 5.6 个月对 5.8 个月，p = 0.266）。dMMR患者的总生存期往往优于pMMR患者，但这一差异无统计学意义（中位数为17.9个月 vs. 12.2个月，p = 0.183）：结论：在mGC患者中，一线FP的疗效并不因MMR状态而异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Gastric Cancer 医学-胃肠肝病学

CiteScore

14.70

自引率

2.70%

发文量

审稿时长

6-12 weeks

期刊介绍： Gastric Cancer is an esteemed global forum that focuses on various aspects of gastric cancer research, treatment, and biology worldwide. The journal promotes a diverse range of content, including original articles, case reports, short communications, and technical notes. It also welcomes Letters to the Editor discussing published articles or sharing viewpoints on gastric cancer topics. Review articles are predominantly sought after by the Editor, ensuring comprehensive coverage of the field. With a dedicated and knowledgeable editorial team, the journal is committed to providing exceptional support and ensuring high levels of author satisfaction. In fact, over 90% of published authors have expressed their intent to publish again in our esteemed journal.