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. 2020 Sep 7:4:26.
doi: 10.1038/s41698-020-00132-5. eCollection 2020.

Association of mismatch repair status with survival and response to neoadjuvant chemo(radio)therapy in rectal cancer

Shu-Biao Ye #  1 , Yi-Kan Cheng #  2 , Lin Zhang #  3   4 , Yi-Feng Zou  1 , Ping Chen  3   5 , Yan-Hong Deng  6 , Yan Huang  7 , Jian-Hong Peng  3   8 , Xiao-Jian Wu  1 , Ping Lan  1
Affiliations

Association of mismatch repair status with survival and response to neoadjuvant chemo(radio)therapy in rectal cancer

Shu-Biao Ye et al. NPJ Precis Oncol. .

Abstract

Prior reports have indicated that defective mismatch repair (MMR) has a favorable impact on outcome in colorectal cancer patients treated with surgery, immunotherapy, or adjuvant chemotherapy. However, the impact of MMR status on response to neoadjuvant radiotherapy in rectal cancer is not well understood. Here we report that dMMR was associated with improved disease-free survival (DFS) (P = 0.034) in patients receiving neoadjuvant chemotherapy (NCT). Patients with dMMR tumors who received neoadjuvant chemoradiotherapy (NCRT) achieved significantly worse DFS (P = 0.026) than those treated with NCT. Conversely, NCRT improved DFS (P = 0.043) in patients with pMMR tumors, especially for stage III disease with improved DFS (P = 0.02). The presence of dMMR was associated with better prognosis in rectal cancer patients treated with NCT. NCT benefited patients with dMMR tumors; while NCRT benefited patients with stage III disease and pMMR tumors. Patients stratified by MMR status may provide a more tailored approach to rectal cancer neoadjuvant therapy.

Keywords: Predictive markers; Radiotherapy; Rectal cancer.

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Conflict of interest statement

Competing interestsThe authors declare no competing interests.

Figures

Fig. 1
Fig. 1. Association between MMR status and disease-free survival (DFS) according to neoadjuvant treatment.
a DFS in patients with neoadjuvant chemotherapy alone (NCT) by DNA mismatch repair (MMR) status. b DFS in patients with neoadjuvant chemoradiotherapy (NCRT) by MMR. dMMR-deficient mismatch repair; pMMR-proficient mismatch repair. HR hazard ratio, CI confidential interval.
Fig. 2
Fig. 2. Association between neoadjuvant treatment and survival according to mismatch repair (MMR) status.
a Disease-free survival (DFS), and b distant metastasis-free survival (DMFS) in patients with deficient MMR (dMMR) by neoadjuvant radiotherapy. c DFS and d Local recurrence-free survival (LRFS) in patients with stage III disease and proficient MMR (pMMR) tumors by neoadjuvant radiotherapy. NCT neoadjuvant chemotherapy, NCRT neoadjuvant chemoradiotherapy, HR hazard ratio, CI confidential interval.
Fig. 3
Fig. 3. Flowchart depicting the process of patient inclusion.
SYSU Sun Yat-sen University, MMR mismatch repair, pMMR proficient mismatch repair, dMMR deficient mismatch repair, NCRT neoadjuvant chemoradiotherapy, NCT neoadjuvant chemotherapy.
See this image and copyright information in PMC

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