@article {Liuejhpharm-2018-001657, author = {Jia Liu and Biao Wang and Wentong Fang}, title = {Microsatellite instability and sensitivity to fluoropyrimidine and oxaliplatin containing first-line chemotherapy in metastatic colorectal cancer}, elocation-id = {ejhpharm-2018-001657}, year = {2018}, doi = {10.1136/ejhpharm-2018-001657}, publisher = {BMJ Specialist Journals}, 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.}, issn = {2047-9956}, URL = {https://ejhp.bmj.com/content/early/2018/11/26/ejhpharm-2018-001657}, eprint = {https://ejhp.bmj.com/content/early/2018/11/26/ejhpharm-2018-001657.full.pdf}, journal = {European Journal of Hospital Pharmacy} }