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

• Rocio Garcia-Carbonero ^[1] ; Beatriz González Astorga ^[12] ; Rosario Vidal Tocino ^[2] ; Débora Contreras Toledo ^[3] ; Carles Pericay ^[13] ; Ana Fernández Montes ^[4] ; Esther Falcó ^[5] ; Marta González Cordero ^[6] ; Juan José Reina Zoilo ^[7] ; Vicente Alonso ^[8] ; Nuria Rodríguez Salas ^[9] ; Mireia Gil-Raga ^[10] ; Cristina Santos ^[14] ; David Páez ^[11] ; Beatriz Anton-Pascual ^[1] ; Fernando Aguilar ^[15] ; Pilar Morales ^[15]
  1. [1] Hospital Universitario 12 de Octubre

     Hospital Universitario 12 de Octubre

     Madrid, España

     
  2. [2] Hospital Universitario de Salamanca

     Hospital Universitario de Salamanca

     Salamanca, España

     
  3. [3] Hospital Universitario Central de Asturias

     Hospital Universitario Central de Asturias

     Oviedo, España

     
  4. [4] Complexo Hospitalario Universitario de Ourense

     Complexo Hospitalario Universitario de Ourense

     Ourense, España

     
  5. [5] Hospital Son Llàtzer

     Hospital Son Llàtzer

     Palma de Mallorca, España

     
  6. [6] Hospital Universitario de Badajoz

     Hospital Universitario de Badajoz

     Badajoz, España

     
  7. [7] Hospital Universitario Virgen Macarena

     Hospital Universitario Virgen Macarena

     Sevilla, España

     
  8. [8] Hospital Miguel Servet

     Hospital Miguel Servet

     Zaragoza, España

     
  9. [9] Hospital Universitario La Paz

     Hospital Universitario La Paz

     Madrid, España

     
  10. [10] Hospital General Universitario de Valencia

      Hospital General Universitario de Valencia

      Valencia, España

      
  11. [11] Hospital de la Santa Creu i Sant Pau

      Hospital de la Santa Creu i Sant Pau

      Barcelona, España

      
  12. [12] Medical Oncology Department, Hospital Universitario Clínico San Cecilio, Granada
  13. [13] Medical Oncology Department, Hospital Universitari Parc Taulí, Sabadell
  14. [14] Medical Oncology Department, Institute Català d’Oncologia IDIBELL, L’Hospitalet, Barcelona
  15. [15] Medical Affairs Department, MSD Spain, Madrid

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• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 26, Nº. 4, 2024, págs. 864-871
• Idioma: inglés
• Texto completo no disponible (Saber más ...)
• 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.