Real-world study on microsatellite instability and mismatch repair deficiency testing patterns among patients with metastatic colorectal cancer in Spain


Por: Garcia-Carbonero R., González Astorga B., Vidal Tocino R., Contreras Toledo D., Pericay C., Fernández Montes A., Falcó E., González Cordero M., Reina Zoilo J.J., Alonso V., Rodríguez Salas N., Gil-Raga M., Santos C., Páez D., Anton-Pascual B., Aguilar F., Morales P.

Publicada: 31 ago 2023 Ahead of Print: 1 ene 2023
Resumen:
PURPOSE: Clinical practice guidelines recommend that all patients with metastatic colorectal cancer (mCRC) should be tested for mismatch repair deficiency (dMMR) or microsatellite instability-high (MSI-H). We aimed to describe the dMMR/MSI-H testing practice in patients with mCRC in Spanish centers. METHODS: Multicenter, observational retrospective study that included patients newly diagnosed with mCRC or who progressed to a metastatic stage from early/localized stages. RESULTS: Three hundred patients were included in the study from May 2020 through May 2021, with a median age of 68 years, and two hundred twenty-five (75%) had stage IV disease at initial diagnosis; two hundred eighty-four patients received first-line treatment, and dMMR/MSI-H testing was performed in two hundred fifty-one (84%) patients. The results of the dMMR/MSI-H tests were available in 61 (24%) of 251 patients before the diagnosis of metastatic disease and in 191 (81%) of 236 evaluable patients for this outcome before the initiation of first-line treatment. Among the 244 patients who were tested for dMMR/MSI-H with IHC or PCR, 14 (6%) were MMR deficient. The most frequent type of first-line treatment was the combination of chemotherapy and biological agent, that was received by 71% and 50% of patients with MMR proficient and deficient tumors, respectively, followed by chemotherapy alone, received in over 20% of patients in each subgroup. Only 29% of dMMR/MSI-H tumors received first-line immunotherapy. CONCLUSION: Our study suggests that a high proportion of patients with mCRC are currently tested for dMMR/MSI-H in tertiary hospitals across Spain. However, there is still room for improvement until universal testing is achieved. TRIAL REGISTRATION: Not applicable.

Filiaciones:
Garcia-Carbonero R.:
 Medical Oncology Department, Hospital Universitario 12 de Octubre, IIS Imas12, UCM, Av Cordoba S/N, Madrid, 28041, Spain

González Astorga B.:
 Medical Oncology Department, Hospital Universitario Clínico San Cecilio, Granada, Spain

Vidal Tocino R.:
 Medical Oncology Department, Complejo Asistencial Universitario de Salamanca, IBSAL, Salamanca, Spain

Contreras Toledo D.:
 Medical Oncology Department, Hospital Universitario Central de Asturias, ISPA, Programa Doctorado en Ciencias de la Salud, Universidad de Oviedo, Oviedo, Spain

Pericay C.:
 Medical Oncology Department, Hospital Universitari Parc Taulí, Sabadell, Spain

Fernández Montes A.:
 Medical Oncology Department, Complexo Hospitalario Universitario de Ourense, Ourense, Spain

Falcó E.:
 Medical Oncology Department, Hospital Son Llatzer, Palma, Spain

González Cordero M.:
 Medical Oncology Department, Hospital Universitario de Badajoz, Badajoz, Spain

Reina Zoilo J.J.:
 Medical Oncology Department, Hospital Universitario Virgen Macarena, Sevilla, Spain

Alonso V.:
 Medical Oncology Department, Hospital Universitario Miguel Servet, Zaragoza, Spain

Rodríguez Salas N.:
 Medical Oncology Department, Hospital Universitario La Paz, Madrid, Spain

Gil-Raga M.:
 Medical Oncology Department, Hospital General Universitario de Valencia, Valencia, Spain

Santos C.:
 Medical Oncology Department, Institute Català d’Oncologia IDIBELL, L’Hospitalet, Barcelona, Spain

Páez D.:
 Medical Oncology Department, U705 (CIBERER), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain

Anton-Pascual B.:
 Medical Oncology Department, Hospital Universitario 12 de Octubre, IIS Imas12, UCM, Av Cordoba S/N, Madrid, 28041, Spain

Aguilar F.:
 Medical Affairs Department, MSD Spain, C/Josefa Valcarcel, 38, Madrid, 28027, Spain

Morales P.:
 Medical Affairs Department, MSD Spain, C/Josefa Valcarcel, 38, Madrid, 28027, Spain
ISSN: 1699048X
Editorial
SPRINGER INTERNATIONAL PUBLISHING AG, GEWERBESTRASSE 11, CHAM, CH-6330, SWITZERLAND, España
Tipo de documento: Article
Volumen: Número:
Páginas:
WOS Id: 001062542500001
ID de PubMed: 37651021
imagen All Open Access; Hybrid Gold

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