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欧洲晚期子宫内膜癌女性中微卫星不稳定性检测及相关情况的真实世界流行率。

Real-world prevalence of microsatellite instability testing and related status in women with advanced endometrial cancer in Europe.

机构信息

OPEN Health, Bethesda, MD, USA.

Merck & Co., Inc., 126 East Lincoln Ave, P.O. Box 2000, Rahway, NJ, 07065, USA.

出版信息

Arch Gynecol Obstet. 2024 Jun;309(6):2833-2841. doi: 10.1007/s00404-024-07504-3. Epub 2024 Apr 18.

Abstract

PURPOSE

To assess the real-world prevalence of microsatellite instability (MSI)/mismatch repair (MMR) testing and related tumor status in recurrent/advanced endometrial cancer patients in Europe.

METHODS

Data were from two multi-center, retrospective patient chart review studies conducted in the United Kingdom, Germany, Italy, France and Spain: The Endometrial Cancer Health Outcomes-Europe-First-Line (ECHO-EU-1L) study and the ECHO-EU-Second-Line (ECHO-EU-2L) study. ECHO-EU-1L included recurrent/advanced endometrial cancer patients who received first-line systemic therapy between 1/JUN/2016 and 31/MAR/2020 after recurrent/advanced diagnosis. ECHO-EU-2L included patients with recurrent/advanced endometrial cancer who progressed between 1/JUN/2016 and 30/JUN/2019 following prior first-line systemic therapy. Data collected included patient demographics, MSI/MMR tumor testing and results, and clinical/treatment characteristics.

RESULTS

ECHO-EU-1L included 242 first-line patients and ECHO-EU-2L included 475 s-line patients. For all patients, median age at recurrent/advanced diagnosis was 69 years, roughly half had endometrioid carcinoma histology and over 75% had Stage IIIB-IV disease at initial diagnosis. The prevalence of MSI/MMR testing in the first-line and second-line cohorts was similar (36.4 and 34.9%, respectively). Among those tested, a majority had non-MSI-high/MMR proficient tumors (80.7 and 74.7% among first- and second-line patients, respectively). About 15% had MSI-high/MMR deficient tumors in both cohorts, and a few patients had discordant results (3.4 and 10.8% among first- and second-line patients, respectively).

CONCLUSION

Prior to the approvals of biomarker-directed therapies for recurrent/advanced endometrial cancer patients in Europe, there were low MSI/MMR testing rates for these patients of just over one-third. Given the availability of biomarker-directed therapies, increased MSI/MMR testing may help inform treatment decisions for recurrent/advanced endometrial cancer patients in Europe.

摘要

目的

评估欧洲复发性/晚期子宫内膜癌患者中微卫星不稳定性(MSI)/错配修复(MMR)检测的真实世界流行率以及相关肿瘤状态。

方法

数据来自于在英国、德国、意大利、法国和西班牙进行的两项多中心、回顾性患者病历审查研究:子宫内膜癌健康结局-欧洲一线(ECHO-EU-1L)研究和 ECHO-EU-二线(ECHO-EU-2L)研究。ECHO-EU-1L 纳入了在复发性/晚期诊断后于 2016 年 6 月 1 日至 2020 年 3 月 31 日期间接受一线全身治疗的复发性/晚期子宫内膜癌患者。ECHO-EU-2L 纳入了在一线全身治疗后于 2016 年 6 月 1 日至 2019 年 6 月 30 日期间进展的复发性/晚期子宫内膜癌患者。收集的数据包括患者的人口统计学资料、MSI/MMR 肿瘤检测及结果以及临床/治疗特征。

结果

ECHO-EU-1L 纳入了 242 名一线患者,ECHO-EU-2L 纳入了 475 名二线患者。对于所有患者,复发性/晚期诊断时的中位年龄为 69 岁,大约一半为子宫内膜样癌组织学类型,初始诊断时超过 75%为 IIIB-IV 期疾病。一线和二线队列中的 MSI/MMR 检测率相似(分别为 36.4%和 34.9%)。在接受检测的患者中,大多数为非 MSI 高/MMR 功能正常的肿瘤(一线和二线患者中分别为 80.7%和 74.7%)。大约 15%的患者在两个队列中均为 MSI 高/MMR 缺陷型肿瘤,少数患者的结果存在差异(一线和二线患者中分别为 3.4%和 10.8%)。

结论

在欧洲批准用于复发性/晚期子宫内膜癌患者的生物标志物导向治疗之前,这些患者的 MSI/MMR 检测率仅略高于三分之一。鉴于生物标志物导向治疗的可用性,增加 MSI/MMR 检测可能有助于为欧洲复发性/晚期子宫内膜癌患者的治疗决策提供信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dfbf/11147824/1934c91b8155/404_2024_7504_Fig1_HTML.jpg

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