Retrospective Analysis of the Correlation of MSI-h/dMMR Status and Response to Therapy for Endometrial Cancer: RAME Study, a Multicenter Experience

SIMPLE SUMMARY: EC is the most common gynecological malignancy, and increased incidence and disease-related mortality have been observed in recent years. Data on the response to first-line carboplatin plus paclitaxel in EC is limited. The RAME study is a retrospective analysis aiming to assess respo...

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Detalles Bibliográficos
Autores principales: Tuninetti, Valentina, Pace, Luca, Ghisoni, Eleonora, Quarà, Virginia, Arezzo, Francesca, Palicelli, Andrea, Mandato, Vincenzo Dario, Geuna, Elena, Cormio, Gennaro, Biglia, Nicoletta, Borsotti, Lucia, Gallo, Silvia, Ferrero, Annamaria, Jacomuzzi, Elena, Fuso, Luca, Pezua Sanjinez, Jeremy Oscar Smith, Puppo, Andrea, Caglio, Andrea, Rognone, Chiara, Turinetto, Margherita, Scotto, Giulia, Di Maio, Massimo, Valabrega, Giorgio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Article
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10377998/
https://www.ncbi.nlm.nih.gov/pubmed/37509300
http://dx.doi.org/10.3390/cancers15143639
Descripción
Sumario:SIMPLE SUMMARY: EC is the most common gynecological malignancy, and increased incidence and disease-related mortality have been observed in recent years. Data on the response to first-line carboplatin plus paclitaxel in EC is limited. The RAME study is a retrospective analysis aiming to assess response to chemotherapy in MSI-h/dMMR and MSI-l/pMMR EC patients. In patients receiving platinum-based chemotherapy in a first-line setting, PFS and OS were numerically longer in the MSI-l/pMMR population compared to MSI-h/dMMR patients. ABSTRACT: Background: There is poor evidence regarding sensitivity to chemotherapy in endometrial cancer (EC) based on microsatellite instability (MSI)/mismatch repair (MMR) status. Methodology: The RAME study is a retrospective analysis aiming to assess response to chemotherapy in MSI-high (h)/deficient (d) MMR and MSI-low (l)/proficient (p) MMR EC patients. Primary endpoints were recurrence-free survival (RFS) for patients with localized disease and progression-free survival (PFS) and overall survival (OS) in patients with advanced/recurrent disease. Results: A total of 312 patients treated between 2010 and 2022 in four high-volume Multicenter Italian Trial in Ovarian cancer and gynecological malignancies (MITO) centers were selected. In total, 239 patients had endometrioid EC (76.6%), 151 had FIGO stage I at diagnosis (48.9%) and 71 were MSI-h/dMMR (22.8%). Median age was 65 (range 31–91) years. Among patients with localized disease, median RFS was 100.0 months (95% CI 59.4–140.7) for MSI-l/pMMR and 120.9 months (60.0–181.8) for MSI-h/dMMR (p = 0.39). Seventy-seven patients received first-line chemotherapy for advanced/recurrent disease. Patients with MSI-h/dMMR ECs had a significantly worse OS (p = 0.039). In patients receiving platinum-based chemotherapy, no statistically significant differences in PFS (p = 0.21) or OS (p = 0.057) were detected, although PFS and OS were numerically longer in the MSI-l/pMMR population. Conclusions: Patients with metastatic MSI-h/dMMR EC receiving first-line chemotherapy had a significantly worse OS.

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