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Review
. 2010 Mar;7(3):174-7.
doi: 10.1038/nrclinonc.2009.235.

DNA mismatch repair and adjuvant chemotherapy in sporadic colon cancer

Frank A Sinicrope  1
Affiliations
Review

DNA mismatch repair and adjuvant chemotherapy in sporadic colon cancer

Frank A Sinicrope. Nat Rev Clin Oncol. 2010 Mar.

Abstract

Defective DNA mismatch repair (MMR) occurs in approximately 15% of sporadic colorectal cancers (CRCs). Multiple retrospective studies have shown that patients with MMR-deficient CRCs have a more favorable stage-adjusted prognosis compared with those who have MMR-proficient tumors. Evidence also indicates that patients with MMR-deficient colon cancers do not benefit from treatment with adjuvant 5-fluorouracil chemotherapy. Furthermore, recent studies, including a pooled analysis, have validated the prognostic and predictive impact of MMR status in patients with stage II and III colon cancer who were treated in adjuvant chemotherapy trials. Given these data, it can be recommended that MMR status be determined and used to inform clinical decision-making for adjuvant chemotherapy in patients with stage II colon cancer.

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Figures

Figure 1
Figure 1
Distinct molecular pathways for the development of defective DNA MMR and MSI-H in CRCs. Lynch syndrome CRCs arise due to germline mutations in MMR genes whereas epigenetic inactivation of the hMLH1 gene characterizes sporadic CRCs with MMR deficiency and MSI-H. Abbreviations: CRC, colorectal cancer; HNPCC, hereditary nonpolyposis colorectal cancer; MMR, mismatch repair; MSI-H, high-frequency microsatellite instability.
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