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错配修复缺陷(dMMR/MSI-H)型子宫内膜癌患者对一线含铂化疗的反应。

Response to first line platinum-based chemotherapy in mismatch repair deficient (MMRd)/ microsatellite instability high (MSI-high) endometrial carcinoma.

机构信息

Department of Medical Oncology, Gustave Roussy Cancer Campus, Paris-Saclay University, Villejuif, France.

Université de Paris, Institut du Cancer Paris CARPEM, AP-HP, APHP.Centre, Department of Medical Oncology, Cochin-Port Royal, Paris, France.

出版信息

Gynecol Oncol. 2023 Feb;169:78-84. doi: 10.1016/j.ygyno.2022.11.029. Epub 2022 Dec 13.

DOI:10.1016/j.ygyno.2022.11.029
PMID:36521352
Abstract

BACKGROUND

Around 15% of metastatic endometrial carcinoma (EC) are MMRd/MSI-H improving response to immune checkpoint inhibitors (ICI). So far, few data existed considering the chemotherapy (CT) sensitivity in MMRd/MSI-H EC, especially response to first-line platinum-based treatment.

PATIENTS AND METHODS

We performed a multicentric retrospective analysis reporting the response to first line platinum CT in MMRd/MSI-H EC patients. The primary endpoints were objective response rate (ORR) and progression-free survival (PFS) with first line platinum-based CT.

RESULTS

A total of 112 patients MMRd/MSI-H EC from 8 centers were identified. Median overall survival was 58.0 months (95% CI: 45.3-95.1). Among them, 78 patients received first line platinum CT in recurrent/metastatic setting. With a median follow up of 32.6 months (min: 0.03; max: 135.0), ORR and DCR (disease control rate) were 50% (95% CI: 38.5-61.5) and 68% (95% CI: 56.4-78.1), respectively. Median PFS and OS from first line platinum-based CT was 7.8 months (95% CI: 6.0-9.0) and 51.9 months (95% CI: 28.0-NE), respectively. Median PFS with ICI in second line (n = 48) was 10.7 months (95% CI: 3.4-NE) from ICI initiation.

CONCLUSION

ORR in first line metastatic MMRd/MSI-H EC is consistent with efficacy in an all comer metastatic EC population.

摘要

背景

约 15%的转移性子宫内膜癌(EC)为错配修复缺陷/微卫星高度不稳定(MMRd/MSI-H),对免疫检查点抑制剂(ICI)的反应有所改善。到目前为止,关于 MMRd/MSI-H EC 患者对化疗(CT)的敏感性,特别是对一线含铂治疗的反应,相关数据很少。

患者和方法

我们进行了一项多中心回顾性分析,报告了 MMRd/MSI-H EC 患者一线铂类 CT 的反应。主要终点是一线含铂 CT 治疗的客观缓解率(ORR)和无进展生存期(PFS)。

结果

共确定了来自 8 个中心的 112 名 MMRd/MSI-H EC 患者。中位总生存期为 58.0 个月(95%CI:45.3-95.1)。其中,78 名患者在复发/转移时接受了一线铂类 CT。中位随访时间为 32.6 个月(min:0.03;max:135.0),ORR 和疾病控制率(DCR)分别为 50%(95%CI:38.5-61.5)和 68%(95%CI:56.4-78.1)。一线含铂 CT 的中位 PFS 和 OS 分别为 7.8 个月(95%CI:6.0-9.0)和 51.9 个月(95%CI:28.0-NE)。二线接受 ICI 的 48 名患者(n=48)从 ICI 开始的中位 PFS 为 10.7 个月(95%CI:3.4-NE)。

结论

一线转移性 MMRd/MSI-H EC 的 ORR 与所有转移性 EC 患者的疗效一致。

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引用本文的文献

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JNCI Cancer Spectr. 2024 Nov 1;8(6). doi: 10.1093/jncics/pkae101.