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Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research

2623 - Prognostic implications of mismatch repair deficiency in patients with early-stage colorectal and endometrial cancer

Date

20 Oct 2018

Session

Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research

Presenters

Elena Fountzila

Citation

Annals of Oncology (2018) 29 (suppl_8): viii649-viii669. 10.1093/annonc/mdy303

Authors

E. Fountzila, V. Kotoula, G. Pentherdoudakis, K. Manousou, E. Vrettou, C. Poulios, C. Papadimitriou, G. Raptou, E. Pectasides, G. Polychronidou, G. Karayannopoulou, S. Chrisafi, P. Papakostas, T. Makatsoris, A. Psyrri, E. Samantas, M. Bobos, C. Christodoulou, D.G. Pectasides, G. Fountzilas

Author affiliations

  • Data Office, Hellenic Cooperative Oncology Group (HeCOG), 11524 - Athens/GR
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Resources

Abstract 2623

Background

The clinical relevance of mismatch repair deficiency (MMRd) in patients with early-stage cancer remains unclear. Our goal was to investigate the prognostic role of MMRd in patients with colorectal and endometrial cancer.

Methods

From 05/1990 to 03/2013, formalin-fixed paraffin-embedded primary tumors were prospectively collected from patients with early-stage colorectal (991) and endometrial (167) cancer, referred to the Departments of Medical Oncology affiliated with the Hellenic Cooperative Oncology Group. Protein expression of MMR proteins was evaluated by immunohistochemistry. The primary outcome measure was overall survival (OS).

Results

Overall, 1158 patients were included (median age, 64 years). Stage III disease was diagnosed in 58% and 19% of patients with colorectal and endometrial cancer, respectively. All patients with colorectal cancer but only 13% of those with endometrial cancer received adjuvant treatment. MMRd was observed in 114 (11.5%) of colorectal and 80 (48%) of endometrial tumors. MMRd was associated with younger age at diagnosis (62 vs. 60y, Mann-Whitney, p = 0.003), higher tumor grade (26.3% vs 16.5%, chi-square, p < 0.001) and lower tumor stage (72% vs. 42.6%, p < 0.001). Colorectal MMRd tumors were more likely right-sided (64.6% vs. 27.2%, p < 0.001), and with a mucinous component (63.7% vs. 41.4%, p < 0.001). Endometrial MMRd tumors were more often endometrioid (74/144, 51.4%) than serous/clear cell (3/15, 20%) carcinomas (p = 0.020). Compared to MMR proficiency, MMRd was associated with improved OS in the entire cohort (HR = 0.66, 95% CI 0.47-0.92, Wald’s p = 0.013) and in patients with endometrial cancer, (HR = 0.39, 95% CI 0.20-0.77, p = 0.006) but not in patients with colorectal cancer (HR = 0.73, 95% CI 0.49-1.09, p = 0.120). In multivariate analysis adjusting for tumor type, stage and grade, MMRd maintained its favorable prognostic significance in the entire cohort (Wald’s p = 0.014) and in patients with endometrial cancer (p = 0.017).

Conclusions

MMRd is associated with improved outcomes in patients with early-stage endometrial cancer, but not in patients with early-stage colorectal cancer.

Clinical trial identification

Legal entity responsible for the study

Hellenic Cooperative Oncology Group.

Funding

Hellenic Cooperative Oncology Group Internal Research Grant.

Editorial Acknowledgement

Disclosure

All authors have declared no conflicts of interest.

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