Universität zu Köln

Stolze, T., Franke, S., Haybaeck, J., Moehler, M., Grimminger, P. P., Lang, H., Roth, W., Gockel, I, Kreuser, N., Blaker, H., Wittekind, C., Lordick, F., Vieth, M., Veits, L., Waidmann, O., Lingohr, P., Peitz, U., Schildberg, C., Kruschewski, M., Vassos, N., Goni, E., Bruns, C. J., Ridwelski, K., Wolff, S., Lippert, H., Schumacher, J., Malfertheiner, P. and Venerito, M. (2023). Mismatch repair deficiency, chemotherapy and survival for resectable gastric cancer: an observational study from the German staR cohort and a meta-analysis. J. Cancer Res. Clin. Oncol., 149 (3). S. 1007 - 1018. NEW YORK: SPRINGER. ISSN 1432-1335

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Abstract

Purpose 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. Methods 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. Results 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). Conclusion 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.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Stolze, T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Franke, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Haybaeck, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Moehler, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Grimminger, P. P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lang, H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Roth, W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Gockel, I UNSPECIFIED UNSPECIFIED UNSPECIFIED Kreuser, N. UNSPECIFIED UNSPECIFIED UNSPECIFIED Blaker, H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wittekind, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lordick, F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Vieth, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Veits, L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Waidmann, O. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lingohr, P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Peitz, U. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schildberg, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kruschewski, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Vassos, N. UNSPECIFIED UNSPECIFIED UNSPECIFIED Goni, E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bruns, C. J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Ridwelski, K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wolff, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lippert, H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schumacher, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Malfertheiner, P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Venerito, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-695954
DOI:	10.1007/s00432-022-03953-y
Journal or Publication Title:	J. Cancer Res. Clin. Oncol.
Volume:	149
Number:	3
Page Range:	S. 1007 - 1018
Date:	2023
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1432-1335
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language EPSTEIN-BARR-VIRUS; MICROSATELLITE INSTABILITY; PROGNOSTIC VALUE; CARCINOMA; ACTIVATION; DIAGNOSIS; THERAPY; RISK Multiple languages Oncology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/69595