دورية أكاديمية
Clinical and Pathologic Response to Neoadjuvant Immunotherapy in DNA Mismatch Repair Protein-Deficient Gastroesophageal Cancers.
| العنوان: | Clinical and Pathologic Response to Neoadjuvant Immunotherapy in DNA Mismatch Repair Protein-Deficient Gastroesophageal Cancers. |
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| المؤلفون: | Shannon AB; Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center, Tampa, FL, USA. adriennebruceshannon@gmail.com., Mehta R; Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center, Tampa, FL, USA., Mok SR; Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center, Tampa, FL, USA., Lauwers GY; Department of Anatomic Pathology, H. Lee Moffitt Cancer Center, Tampa, FL, USA., Baldonado JJAR; Department of Thoracic Oncology, H. Lee Moffitt Cancer Center, Tampa, FL, USA., Fontaine J; Department of Thoracic Oncology, H. Lee Moffitt Cancer Center, Tampa, FL, USA., Pimiento JM; Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center, Tampa, FL, USA., Sinnamon AJ; Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center, Tampa, FL, USA. |
| المصدر: | Annals of surgical oncology [Ann Surg Oncol] 2024 Aug 17. Date of Electronic Publication: 2024 Aug 17. |
| Publication Model: | Ahead of Print |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Springer Country of Publication: United States NLM ID: 9420840 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1534-4681 (Electronic) Linking ISSN: 10689265 NLM ISO Abbreviation: Ann Surg Oncol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2005- : New York, NY : Springer Original Publication: New York, NY : Raven Press, c1994- |
| مستخلص: | Background: Mismatch repair deficient (dMMR) gastroesophageal cancers (GEC) are a distinct subgroup. Among patients with locally advanced disease, previous trial data suggest a good response to neoadjuvant immune checkpoint inhibitors (nICI). Patients and Methods: Since 2019, our institution has routinely performed MMR testing for new GEC cases. Patients diagnosed with GEC (2019-2024) were included in the study. Quantitative data are described as the median and interquartile range (IQR); qualitative data are described as quantities and percentages. Results: A total of 24 patients with dMMR GEC were identified following implementation of routine immunohistochemical testing; 14 were potentially resectable with a median follow-up of 14 months (IQR 8-27). All patients underwent pre-treatment positron emission tomography (PET; median SUV 20.9). Among the 14 potentially resectable patients, 4 underwent immediate surgery, 10 were treated with nICI, and 5 underwent surgical resection to date. All regimens included PD-1 inhibitors, with 70% receiving pembrolizumab. Re-staging PET was performed in five patients; the median post-nICI SUV was 5.1 (range 4.7-6.3). All resected specimens had gross ulceration after nICI, but 60% (N = 3) had a pathologic complete response (pCR) following nICI; one patient had a near-complete response (nCR) and one patient had a partial response (pPR). Reduction in SUV was 75% and 82% in the pCR patients, 25% in the nCR patient, and 43% in the pPR patient. Conclusions: dMMR GECs are responsive to nICI in this limited experience, mirroring early clinical trial data. Given persistent metabolic activity and visible ulceration despite pCR, studies should continue to optimize tools for estimating post-nICI pCR in these patients. (© 2024. Society of Surgical Oncology.) |
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| فهرسة مساهمة: | Keywords: Gastric cancer; Gastroesophageal cancer; Immunotherapy; Microsatellite instability; Mismatch repair protein deficient; Neoadjuvant treatment response |
| تواريخ الأحداث: | Date Created: 20240817 Latest Revision: 20240817 |
| رمز التحديث: | 20240818 |
| DOI: | 10.1245/s10434-024-16030-0 |
| PMID: | 39154152 |
| قاعدة البيانات: | MEDLINE |
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