Efficacy of anti-VEGF & anti-EGFRs in microsatellite instable (MSI-H) metastatic colorectal cancer, Turkish Oncology Group (TOG) study.
e15507 Background: Mismatch repair deficient (dMMR)/microsatellite instability-high (MSI-H) CRC tumors constitute of 5% of mCRC. Immunotherapy is a new standard, but it is difficult to give it all. 5FU based treatment with antiEGFRs in RAS/BRAF-wt or bevacizumab (B) is used in mCRC. Data is limited for the efficacy of B or antiEGFRs in dMMR/MSI-H mCRC due to small number of cases in CRC population in trials. Aims : Evaluation of prognostic factors & 1 st line 5FU based treatment with B/antiEGFRs efficacy in mCRC. Methods: dMMR/MSI-H mCRC patients (pts) with 1 st line B/antiEGFRs were evaluated retrospectively. Results: 132 patients were included. Mutation rates were as 35.6% (n:47) for RAS, 12.1% (n:16) for BRAF.Median PFS was 10.9 (95%CI: 9.2-12.6) months. Median OS was 44 months (95% CI 26.23-63.03). 82 (62.1%) pts had primary tumor resection (PTR), 26 (19.7%) had PTR & metastasectomy. 17 (12.8%) de novo mCRC pts had maximal cytoreductive surgery (MCS). 14 (10.6%) pts had subsequent IO. In multivariate analysis, RAS/BRAF mutation status, MCS & subsequent IO are defined as prognostic factors for OS (p<0.01, p: 0.022, p: 0.005, respectively). No statistically significant survival (PFS, OS) difference was detected. Conclusions: dMMR/MSI-H mCRC is an entity with different tumor biology. We consider that dMMR/MSI-H mCRC pts with BRAF wt, MCS & subsequent IO have better outcomes with 1st line 5FU based treatment with B/antiEGFRs. Baseline characteristics & survival analysis. n(%) PFS(months) OS (months) Univariate analysis Univariate analysis Multivariate analysis %95 CI P value %95 CI P value %95 CI HR P value Age (year) 60(23-82) 0.86 0.62 <60 50 8.4-11.3 25.0-64.7 ≥60 72 9.8-15.1 17.4-71.8 Sex 0.55 Female 56(43.2) 7.5-14.7 6.7-58.5 0.59 Male 67(50.8) 7.5-12.4 26.9-62.3 Primary Tumor Location 0.045 0.036 Right 81(61.4) 7.9-10.7 24.7-85.6 Left 33(25) 9.1-15.8 16.0-73.7 <jats:t
Authors
- Murat Kiracı (ORCID: https://orcid.org/0000-0003-3041-0134)
- Beliz Bahar Karaoğlan (ORCID: https://orcid.org/0000-0002-5021-7588)
- Esma Türkmen (ORCID: https://orcid.org/0000-0003-1803-2409)
- Nargız Majidova (ORCID: https://orcid.org/0000-0002-2575-5819)
- Sabin Göktaş Aydın (ORCID: https://orcid.org/0000-0002-0077-6971)
- Taha Koray Şahin (ORCID: https://orcid.org/0000-0002-3590-0426)
- Ali Oğul (ORCID: https://orcid.org/0000-0003-4886-7060)
- Yakup Ergün (ORCID: https://orcid.org/0000-0003-4784-6743)
- Zeynep Yüksel Yaşar (ORCID: https://orcid.org/0000-0002-2929-5039)
- Emine Türkmen (ORCID: https://orcid.org/0000-0002-3356-5871)
- Öztürk Ateş (ORCID: https://orcid.org/0000-0003-0182-3933)
- Mutlu Doğan (ORCID: https://orcid.org/0000-0001-9359-3770)
- Kadriye Başkurt (ORCID: https://orcid.org/0000-0002-6091-730X)
- Elif Şahin (ORCID: https://orcid.org/0000-0002-1976-3951)
- Abdullah Sakin (ORCID: https://orcid.org/0000-0003-2538-8569)
- Ahmet Melih Arslan (ORCID: https://orcid.org/0000-0002-6126-4611)
- Şafak Yıldırım Dişli (ORCID: https://orcid.org/0000-0002-5869-0679)
- Mehmet Akif Öztürk (ORCID: https://orcid.org/0000-0003-1365-7944)
- İlknur Deliktaş Onur (ORCID: https://orcid.org/0000-0001-9884-5789)
- Eda Karapeli̇t Agi̇toğlu (ORCID: https://orcid.org/0009-0006-1583-6910)
Institutions
- Ankara University (TR)
- Manisa Celal Bayar University (TR)
- Bilkent University (TR)
- Dokuz Eylül University (TR)
- Istanbul Medipol University (TR)
- Memorial Ankara Hospital (TR)
- Necmettin Erbakan University (TR)
- Ankara Onkoloji Eğitim ve Araştırma Hastanesi (TR)
- Memorial Sisli Hospital (TR)
- Kayseri Eğitim ve Araştırma Hastanesi (TR)
- Sağlık Bilimleri Üniversitesi (TR)
- İstanbul Kanuni Sultan Süleyman Eğitim ve Araştırma Hastanesi (TR)
- Kocaeli Üniversitesi (TR)
- Hacettepe University (TR)
- Marmara University (TR)
Publication Details
- Journal
- Journal of Clinical Oncology
- Published
- 2025-05-28
- DOI
- https://doi.org/10.1200/jco.2025.43.16_suppl.e15507
- Citations
- 1
- Primary Topic
- Colorectal Cancer Treatments and Studies
- Type
- article
- Field-Weighted Citation Impact
- 1.05