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Microsatellite instability and sensitivity to fluoropyrimidine and oxaliplatin containing first-line chemotherapy in metastatic colorectal cancer
  1. Jia Liu1,
  2. Biao Wang2,
  3. Wentong Fang2
  1. 1Department of Pharmacy, Northern Jiangsu People’s Hospital, Yangzhou, China
  2. 2Department of Pharmacy, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
  1. Correspondence to Wentong Fang, Department of Pharmacy, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China; fangwentong{at}jsph.org.cn

Abstract

Objectives To examine the effect of microsatellite instability (MSI) on the outcome of fluoropyrimidine and oxaliplatin containing first-line chemotherapy in metastatic colorectal cancer (mCRC).

Methods Patients with mCRC and treated with fluoropyrimidine/oxaliplatin first-line chemotherapy were included in our study. Demographic data, tumour characteristics, chemotherapy regimens, treatment responses and progression-free survival (PFS) were collected from medical records. The MSI analysis was performed using fluorescence-based PCR, and divided into MSI-high (MSI-H) and MSI-low (MSI-L)/microsatellite stable (MSS). Statistical analysis used Kaplan-Meier method, log-rank test and multivariate Cox model.

Results From 1 January 2015 to 1 May 2016, a total of 192 patients with mCRC were included in our study. Among these, 14 (7.29%) exhibited MSI-H and 178 (92.71%) were MSI-L/MSS. The objective response rate (p=0.79), disease control rate (p=0.22) and PFS (p=0.22) of fluoropyrimidine/oxaliplatin first-line chemotherapy were not significantly different between MSI-H and MSI-L/MSS tumours. But MSI-H tumours had a trend to better disease control rate (71.43% vs 54.49%) and PFS (6.50 m vs 5.40 m) than MSI-L/MSS tumours. Multivariate analysis indicated that MSI was not a predictive factor for PFS (p=0.18).

Conclusion The effect of fluoropyrimidine/oxaliplatin first-line chemotherapy was not significantly different between MSI-H and MSI-L/MSS tumours. However, MSI-H tumours tended to have better disease control rate and PFS.

  • metastatic colorectal cancer
  • microsatellite instability
  • chemotherapy
  • oxaliplatin
  • predictive marker

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