Deficient MMR phenotype linked to favorable FOLFOX colon cancer DFS
medwireNews: In patients with stage III colon cancer treated with adjuvant FOLFOX chemotherapy, DNA mismatch repair (MMR) deficiency is associated with longer disease-free survival (DFS) than MMR proficiency, confirms a pooled analysis published in JAMA Oncology.
Among 2501 FOLFOX-treated participants of the phase III NCCTG N0147 and PETACC8 trials, the 3-year DFS rate was comparable for the 10.1% of patients determined to be MMR deficient on the basis of immunohistochemistry or microsatellite instability testing and the remaining 89.9% who were MMR proficient, at 75.6% and 74.4%, respectively.
But after accounting for a raft of confounders, such as age, sex, and primary tumor site, MMR deficiency was associated with a significant 27% reduced risk for recurrence or death.
Researcher Aziz Zaanan (European Georges Pompidou Hospital, Paris, France) and co-workers point out that the survival benefit conferred by an MMR deficient status is “clinically meaningful,” and they conclude: “Future clinical trials in the adjuvant setting should consider this molecular characteristic as an important stratification factor.”
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