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Impact of mismatch repair deficiency on tumour regression grade after neoadjuvant chemotherapy in localized gastroesophageal adenocarcinoma

  • Maximilien Heran
    Correspondence
    Corresponding author.
    Affiliations
    Department of Medical Oncology, Saint-Antoine Hospital, AP-HP, 184 rue du Faubourg Saint-Antoine, Paris 75012, France
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  • Florence Renaud
    Affiliations
    Department of Pathology, Claude Huriez University Hospital, Lille, France
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  • Christophe Louvet
    Affiliations
    Department of Medical Oncology, Institut Mutualiste Montsouris, Paris, France
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  • Guillaume Piessen
    Affiliations
    CHU Lille, Department of Digestive and Oncological Surgery, Claude Huriez Hospital, Lille F-59000, France

    CNRS, Inserm, CHU Lille, UMR9020-U1277 - CANTHER - Cancer Heterogeneity, Plasticity and Resistance to Therapies, University Lille, Lille F-59000, France
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  • Thibault Voron
    Affiliations
    Department of Digestive Surgery, Saint-Antoine Hospital, AP-HP, Sorbonne University, Paris, France
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  • Marine Lefèvre
    Affiliations
    Department of Pathology, Institut Mutualiste Montsouris, Paris, France
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  • Olivier Dubreuil
    Affiliations
    Department of Digestive Oncology, Groupe Hospitalier Diaconesses Croix Saint Simon, Paris, France
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  • Thierry André
    Affiliations
    Department of Medical Oncology, Saint-Antoine Hospital, AP-HP; SIRIC CURAMUS, INSERM, Unité Mixte de Recherche Scientifique 938, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe Labellisée par la Ligue Nationale Contre le Cancer, Sorbonne University, Paris, France
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  • Magali Svrcek
    Affiliations
    Department of Pathology, Saint-Antoine Hospital, AP-HP; SIRIC CURAMUS, INSERM, Unité Mixte de Recherche Scientifique 938, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe Labellisée par la Ligue Nationale Contre le Cancer, Sorbonne University, Paris, France
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  • Romain Cohen
    Affiliations
    Department of Medical Oncology, Saint-Antoine Hospital, AP-HP; SIRIC CURAMUS, INSERM, Unité Mixte de Recherche Scientifique 938, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe Labellisée par la Ligue Nationale Contre le Cancer, Sorbonne University, Paris, France
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      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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