Abstract
Background
The use of neoadjuvant chemotherapy (NAC) in patients with mismatch repair (MMR) deficient
(dMMR) localized gastric and oeso-gastric junction (OGJ) adenocarcinoma is subject
of debate. Histological response assessment might help to better evaluate the impact
of dMMR on response to NAC.
Methods
Patients with localized gastric/OGJ adenocarcinoma resected after NAC were retrospectively
identified. MMR protein expression status was assessed by immunohistochemistry. The
primary objective was the frequency of histological responders to NAC defined by tumour
regression grade (TRG) using Mandard's (TRG1-2) and Becker's (TRG1) classifications,
according to the MMR status.
Results
In total, 247 patients with 43 dMMR and 204 pMMR gastric/OGJ adenocarcinoma were identified.
Among dMMR tumours, 18 (42%) arose from the OGJ. Histological response (Becker TRG1-2)
was observed for 28% and 35% of dMMR and pMMR tumours, respectively (p = 0.35). Similar results were observed with Mandard classification. With a median
follow-up of 37.5 months, median disease-free and overall survival were not reached
for the dMMR group.
Conclusion
Histological response after NAC in patients with localized dMMR gastric/OGJ adenocarcinoma
is not statistically different to those with pMMR tumours. This study provides additional
data for the discussion about avoiding NAC in patients with dMMR gastric/OGJ adenocarcinomas.
Keywords
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Article info
Publication history
Published online: June 29, 2022
Accepted:
June 12,
2022
Received:
April 1,
2022
Identification
Copyright
© 2022 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
