Prognostic Impact of Deficient DNA Mismatch Repair in Patients With Stage III Colon Cancer From a Randomized Trial of FOLFOX-Based Adjuvant Chemotherapy

Abstract

The prognostic impact of MMR depended on tumor site, and this interaction was validated in an independent cohort. Among dMMR cancers, proximal tumors had favorable outcome, whereas distal or N2 tumors had poor outcome. BRAF or KRAS mutations were independently associated with adverse outcome.

The current value of determining the mismatch repair status of colorectal cancer: A rationale for routine testing

“…In prospectively col- (Andre et al, 2015;Gavin et al, 2013;Guastadisegni et al, 2010;Klingbiel et al, 2015;Popat et al, 2005;Roth et al, 2012;Sinicrope et al, 2015). lected tumor tissue MSI was detected in 314 of 2580 stage-III CRCs and was prognostic overall for time to relapse (TTR), but not for DFS or OS (Sinicrope et al, 2013a). However, MSI was associated with significantly improved DFS among tumours in the proximal colon (HR = 0.71; 95% CI: 0.53-0.94; P = 0.018), but not in the distal after adjustment for KRAS and BRAF mutations and covariates (Kawakami et al, 2015;Sinicrope et al, 2013a).…”

“…lected tumor tissue MSI was detected in 314 of 2580 stage-III CRCs and was prognostic overall for time to relapse (TTR), but not for DFS or OS (Sinicrope et al, 2013a). However, MSI was associated with significantly improved DFS among tumours in the proximal colon (HR = 0.71; 95% CI: 0.53-0.94; P = 0.018), but not in the distal after adjustment for KRAS and BRAF mutations and covariates (Kawakami et al, 2015;Sinicrope et al, 2013a). Available data in stage-III CRC patients does not change the current approach of treating these patients, irrespective of MMR status, with adjuvant FOLFOX.…”

¿Existen ventajas clínicas al evaluar el estado de los genes KRAS, NRAS, BRAF, PIK3CA, PTEN y HER2 en pacientes con cáncer colorrectal?

“…El cáncer colorrectal en estadio clínico III con deficiencia de la reparación del mal apareamiento del ADN (dMMR), ubicado en el colon distal o con un estado ganglionar N2, tiene un pronóstico malo; esto, independientemente del resultado adverso por mutaciones de KRAS o BRAF 93,94 .…”

Genomic Profiling in Gastrointestinal Cancer: Are We Ready To Use These Data to Make Treatment Decisions?

“…The prognostic value of MSI has subsequently been confirmed in several studies, including a large meta-analysis with 12,782 patients [23,24]. When separating MSI-high tumors further into those associated with Lynch syndrome and sporadic dMMR tumors, it appears that the Lynch syndrome patients might benefit from 5-FU and the sporadic patients would not [25].…”