Efficacy of Adjuvant Chemotherapy in Colon Cancer With Microsatellite Instability: A Large Multicenter AGEO Study

Abstract

This study supports the use of adjuvant chemotherapy with fluoropyrimidine plus oxaliplatin in stage III dMMR CC.

Clinical and molecular characterisation of hereditary and sporadic metastatic colorectal cancers harbouring microsatellite instability/DNA mismatch repair deficiency

“…retrospectively collected FFPE samples). Indeed, 22% of patients with MLH1/PMS2-negative mCRC would have been misclassified using widely-used algorithms combining MMR immunohistochemistry, BRAF mutation, age and Amsterdam II criteria [8,9]. Notably, 38% of sporadic MSI/dMMR mCRCs were BRAF wild-type but MLH1 hypermethylated.…”

“…However, the addition of oxaliplatine to fluoropyrimidines seems associated with a survival benefit for patients with high-risk stage II or stage III MSI/dMMR CRCs [7,8]. Sensitivity to fluoropyrimidine may differ between sporadic and hereditary stage III MSI/dMMR CRCs [8,9].…”

“…Sensitivity to fluoropyrimidine may differ between sporadic and hereditary stage III MSI/dMMR CRCs [8,9]. In metastatic setting, the poor prevalence of MSI/dMMR (3-5%) hampers the evaluation of its prognostic value, and results from early studies were inconsistent [10][11][12][13][14].…”

“…MMR testing and BRAF status when available; if not, age inferior to 60 years or Amsterdam II criteria) [8,9].…”

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

“…A DFS benefit from FOLFOX compared with 5-FU alone was observed in a small number of patients with dMMR CRC (Andre et al, 2015). Moreover, a recent study involving 433 dMMR stage-II and stage-III tumours found that adjuvant FOLFOX improved DFS compared to 5-FU alone, with the benefit limited to stage-III tumours and to sporadic cases only (Tougeron et al, 2016).…”