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Springer Nature [academic journals on nature.com], British Journal of Cancer, 2(124), p. 399-406, 2020

DOI: 10.1038/s41416-020-01076-0

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

Journal article published in 2020 by G. Emerens Wensink ORCID, Marloes A. G. Elferink, Anne M. May, Linda Mol, Patricia A. H. Hamers, Sandra D. Bakker, Geert-Jan Creemers, Jan Willem B. de Groot, Gerty J. de Klerk, Brigitte C. M. Haberkorn, Annebeth W. Haringhuizen, Ronald Hoekstra, J. Cornelis B. Hunting, Emile D. Kerver, Danielle Mathijssen-Van Stein and other authors.
This paper was not found in any repository, but could be made available legally by the author.
This paper was not found in any repository, but could be made available legally by the author.

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Abstract

AbstractBackgroundMetastatic 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.MethodsTwo 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.ResultsOf 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.ConclusionAvailable 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.