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• W2287581330 abstract "3518 Background: dMMR is a favorable prognostic marker and a predictive marker for lack of benefit from 5FU-based adjuvant chemotherapy (AT). To better understand the relationship between MMR status, treatment benefit, relapse, and survival, time patterns of recurrence risk (RR) in patients with dMMR and proficient MMR (pMMR) tumors were compared. Methods: 1,562 patients (pts) from randomized phase III trials including 5FU-based AT and surgery alone (S) arms were analyzed. The trials included data previously presented by Sargent (ASCO 2008) and additional data from several NSABP trials. Tumors from stage II (n=757) and III (n=805) pts were assayed for MMR status. Time- dependent patterns of recurrence (TTR), disease free (DFS), and overall survival (OS) were analyzed by MMR status and treatment received. Results: Over the 8-year study period, in pts treated with S alone, dMMR pts maintained a consistent advantage in the endpoints TTR, DFS, OS compared to pMMR pts (see Table). dMMR pts treated with S alone had an approximately two-fold lower RR than pMMR pts in particular during the first 4 years after treatment. dMMR patients recur less overall, without a trend towards later recurrences. 5FU-based AT provided pMMR pts a pronounced RR reduction within the first four years of follow-up that is not observed in dMMR pts, in whom AT was not associated with a reduced RR. Survival is poor (∼ 1 year) following recurrence and is independent of MMR status (p=0.71 S, p=0.99 AT). Conclusions: The favorable prognosis and low RR in dMMR pts is maintained throughout the natural course of the disease. In particular, in dMMR pts, the RR is low, and no benefit from AT is observed at any point. Conversely, pMMR pts have an increased RR during the first four years postsurgery that is significantly reduced with 5FU-based AT. Annualized risk for recurrence MMR status Year 0-2 Years 2-4 Years 4-6 Years 6-8 S AT S AT S AT S AT dMMR 16.8% 15.5% 4.8% 5.2% 3.8% 2.7% 0.0% 2.3% pMMR 25.1% 18.1% 13.1% 8.2% 4.1% 4.6% 1.8% 0.7% No significant financial relationships to disclose." @default.
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• W2287581330 date "2010-05-20" @default.
• W2287581330 modified "2023-10-16" @default.
• W2287581330 title "Analysis of time-dependent patterns of treatment effect and failure to explain the predictive role of deficient mismatch repair (dMMR) in stage II and III colon cancer (CC)." @default.
• W2287581330 doi "https://doi.org/10.1200/jco.2010.28.15_suppl.3518" @default.
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