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Abstract
Introduction. The development of microsatellite instability as a result of germline or sporadic mutations in the genes of the mismatched nucleotide repair (MMR) system is a key link in triggering the mechanisms of carcinogenesis through the formation of tumor neoantigens that are targets for T lymphocytes, which ultimately determines the high immunogenicity of these tumors and their sensitivity to immune checkpoint inhibitors.
Aim. To determine the clinical and morphological characteristics of gastric, colon and rectal tumors with microsatellite instability.
Materials and Methods. The retrospective analysis included 76 patients with established dMMR (36 patients with colorectal cancer and 42 patients with gastric malignancies).
Results. Common characteristics for the above described tumors are: locally advanced nature of the process (T3-T4, N2-N3), complicated course of the disease, predominant in IHC testing, loss of PMS2, MLH1 proteins, progression and low rate of achieving objective response against the background of PCT, high efficacy of IT alone or in combination with PCT (disease control rate (65 % and 73.68 % for gastric and colorectal cancer, respectively); median progression-free survival in patients who completed treatment with checkpoint inhibitors was not as high as in the gastric and colorectal cancer groups.
References
Мусаелян А.А., Оганян К.А., Назаров В.Д., et al. Микросателлитная нестабильность при раке желудка: основы и клиническое применение. Эффективная фармакотерапия. 2021; 17(30): 12-17.-DOI: https://doi.org/10.33978/2307-3586-2021-17-30-12-17. [Musaelyan A.A., Ohanyan K.A., Nazarov V.D., et al. Microsatellite instability in gastric cancer: fundamentals and clinical application. Effective Pharmacotherapy. 2021; 17(30): 12-17.-DOI: https://doi.org/10.33978/2307-3586-2021-17-30-12-17. (In Rus)].
Оганян К.А., Мусаелян А.А., Котикова М.А., et al. Молекулярно-генетическая характеристика колоректального рака в зависимости от статуса микросателлитной нестабильности. Медицинский совет. 2022; 16(9): 139-146.-DOI: https://doi.org/10.21518/2079-701X-2022-16-9-139-146.-EDN: ADRJVH. [Oganyan K.A., Musaelyan A.A., Kotikova M.A., et al. Molecular genetic characteristics of colorectal cancer depending on the status of microsatellite instability. Meditsinskiy Sovet = Medical Council. 2022; (9): 139-46.-DOI: https://doi.org/10.21518/2079-701x-2022-16-9-139-146.-EDN: ADRJVH. (In Rus)].
Geiersbach K.B., Samowitz W.S. Microsatellite instability and colorectal cancer. Arch Pathol Lab Med. 2011; 135(10): 1269-77.-DOI: https://doi.org/10.5858/arpa.2011-0035-ra.
Swets M., Graham Martinez C., van Vliet S., et al. Microsatellite instability in rectal cancer: what does it mean? A study of two randomized trials and a systematic review of the literature. Histopathology. 2022; 81(3): 352-62.-DOI: https://doi.org/10.1111/his.14710.
Puliga E., Corso S., Pietrantonio F., Giordano S. Microsatellite instability in gastric cancer: Between lights and shadows. Cancer Treat Rev. 2021; 95: 102175.-DOI: https://doi.org/10.1016/j.ctrv.2021.102175.
Boland C.R., Goel A. Microsatellite instability in colorectal cancer. Gastroenterol. 2010; 138(6): 2073-2087.e3.-DOI: https://doi.org/10.1053/j.gastro.2009.12.064.
Chao J., Fuchs C.S., Shitara K., et al. Assessment of pembrolizumab therapy for the treatment of microsatellite instability–high gastric or gastroesophageal junction cancer among patients in the KEYNOTE-059, KEYNOTE-061, and KEYNOTE-062 clinical trials. JAMA Oncology. 2021; 7(6): 895.-DOI: https://doi.org/10.1001/jamaoncol.2021.0275.
Gong X.L., Zhao L. Immune checkpoint inhibitors in the treatment of colorectal cancer: a review of clinical trials. Zhonghua Wei Chang Wai Ke Za Zhi. 2022; 25(3): 205-213.-DOI: https://doi.org/10.3760/cma.j.cn441530-20211219-00509.
Diaz L.A., Shiu K.K., Kim T.W., et al. Pembrolizumab versus chemotherapy for microsatellite instability-high or mismatch repair-deficient metastatic colorectal cancer (KEYNOTE-177): final analysis of a randomised, open-label, phase 3 study. Lancet Oncol. 2022; 23(5): 659-70.-DOI: https://doi.org/10.1016/s1470-2045(22)00197-8.
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