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Consequences of a h...
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Aasebö, Kristine Ö.Univ Bergen, Dept Clin Sci, Bergen, Norway
(author)
Consequences of a high incidence of microsatellite instability and BRAF-mutated tumors : A population-based cohort of metastatic colorectal cancer patients
- Article/chapterEnglish2019
Publisher, publication year, extent ...
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2019-05-09
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WILEY,2019
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electronicrdacarrier
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LIBRIS-ID:oai:DiVA.org:uu-391954
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-391954URI
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https://doi.org/10.1002/cam4.2205DOI
Supplementary language notes
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
Notes
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Background: Immunotherapy for patients with microsatellite-instable (MSI-H) tumors or BRAF-inhibitors combination treatment for BRAF-mutated (mutBRAF) tumors in metastatic colorectal cancer (mCRC) is promising, but the frequency of these molecular changes in trial patients are low. Unselected population-based studies of these molecular changes are warranted.Methods: A population-based cohort of 798 mCRC patients in Scandinavia was studied. Patient and molecular tumor characteristics, overall survival (OS) and progression-free survival (PFS) were estimated.Results: Here, 40/583 (7%) tumor samples were MSI-H and 120/591 (20%) were mutBRAF; 87% of MSI-H tumors were mutBRAF (non-Lynch). Elderly (>75 years) had more often MSI-H (10% vs 6%) and MSI-H/mutBRAF (9% vs 4%) tumors. Response rate (5% vs 44%), PFS (4 vs 8 months), and OS (9 vs 18 months) after first-line chemotherapy was all significantly lower in patients with MSI-H compared to patients with microsatellite stable tumors. MSI-H and mutBRAF were both independent poor prognostic predictors for OS (P = 0.049, P < 0.001) and PFS (P = 0.045, P = 0.005) after first-line chemotherapy. Patients with MSI-H tumors received less second-line chemotherapy (15% vs 37%, P = 0.005).Conclusions: In unselected mCRC patients, MSI-H and mutBRAF cases were more common than previously reported. Patients with MSI-H tumors had worse survival, less benefit from chemotherapy, and they differed considerably from recent third-line immunotherapy trial patients as they were older and most had mutBRAF tumor (non-Lynch).
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Dragomir, AncaUppsala universitet,Klinisk och experimentell patologi,Fredrik Pontén(Swepub:uu)ancadrag
(author)
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Sundström, MagnusUppsala universitet,Klinisk och experimentell patologi(Swepub:uu)magnsund
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Mezheyeuski, ArturUppsala universitet,Experimentell och klinisk onkologi(Swepub:uu)artme913
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Edqvist, Per-Henrik DUppsala universitet,Experimentell och klinisk onkologi(Swepub:uu)peedq227
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Eide, Geir EgilUniv Bergen, Dept Global Publ Hlth & Primary Care, Lifestyle Epidemiol Grp, Bergen, Norway;Haukeland Hosp, Ctr Clin Res, Bergen, Norway
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Pontén, FredrikUppsala universitet,Science for Life Laboratory, SciLifeLab,Klinisk och experimentell patologi(Swepub:uu)fredpont
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Pfeiffer, PerOdense Univ Hosp, Dept Oncol, Odense, Denmark
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Glimelius, BengtUppsala universitet,Experimentell och klinisk onkologi(Swepub:uu)bengglim
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Sorbye, HalfdanUniv Bergen, Dept Clin Sci, Bergen, Norway;Haukeland Hosp, Dept Oncol, Bergen, Norway
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Univ Bergen, Dept Clin Sci, Bergen, NorwayKlinisk och experimentell patologi
(creator_code:org_t)
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In:Cancer Medicine: WILEY8:7, s. 3623-36352045-7634
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