Evidence map›Paper›PMID 19165197›Full record

Trial reportBritish journal of cancer2009

Deficient mismatch repair system in patients with sporadic advanced colorectal cancer.

M Koopman, G A M Kortman, L Mekenkamp, M J L Ligtenberg, N Hoogerbrugge, N F Antonini, C J A Punt, J H J M van Krieken

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in British journal of cancer, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03832621 (NIVOLUMAB Plus IPILIMUMAB and TEMOZOLOMIDE in Combination in Microsatellite Stable), which is not on this map. Cited by 284 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
284citing papers in PubMed, 6 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03832621 phase2completednot on this mapstarted 2019, after this paper: background citation

NIVOLUMAB Plus IPILIMUMAB and TEMOZOLOMIDE in Combination in Microsatellite Stable (MSS), MGMT Silenced Metastatic Colorectal Cancer (mCRC): the MAYA Study

TypeinterventionalSponsorFondazione IRCCS Istituto Nazionale dei Tumori, MilanoRan2019 to 2021Enrolled135ConditionsMetastatic Colorectal CancerArmsTemozolomide, Nivolumab, Ipilimumab
3 · Its place in the literature

Who cites it

284 citing papers in PubMed, 6 syntheses or guidelines pooled it.

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  4. Treatment of Metastatic Colorectal Cancer: ASCO Guideline.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2023
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224 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

M KoopmanDepartment of Medical Oncology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. m.koopman@aig.umcn.nl
G A M Kortman
L Mekenkamp
M J L Ligtenberg
N Hoogerbrugge
N F Antonini
C J A Punt
J H J M van Krieken

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

A deficient mismatch repair system (dMMR) is present in 10-20% of patients with sporadic colorectal cancer (CRC) and is associated with a favourable prognosis in early stage disease. Data on patients with advanced disease are scarce. Our aim was to investigate the incidence and outcome of sporadic dMMR in advanced CRC. Data were collected from a phase III study in 820 advanced CRC patients. Expression of mismatch repair proteins was examined by immunohistochemistry. In addition microsatellite instability analysis was performed and the methylation status of the MLH1 promoter was assessed. We then correlated MMR status to clinical outcome. Deficient mismatch repair was found in only 18 (3.5%) out of 515 evaluable patients, of which 13 were caused by hypermethylation of the MLH1 promoter. The median overall survival in proficient MMR (pMMR), dMMR caused by hypermethylation of the MLH1 promoter and total dMMR was 17.9 months (95% confidence interval 16.2-18.8), 7.4 months (95% CI 3.7-16.9) and 10.2 months (95% CI 5.9-19.8), respectively. The disease control rate in pMMR and dMMR patients was 83% (95% CI 79-86%) and 56% (30-80%), respectively. We conclude that dMMR is rare in patients with sporadic advanced CRC. This supports the hypothesis that dMMR tumours have a reduced metastatic potential, as is observed in dMMR patients with early stage disease. The low incidence of dMMR does not allow drawing meaningful conclusions about the outcome of treatment in these patients.

Indexed as

Adaptor Proteins, Signal TransducingAdenocarcinomaAdenocarcinoma, MucinousAdultAgedAged, 80 and overAntineoplastic Combined Chemotherapy ProtocolsCamptothecinCapecitabineCarcinoma, AdenosquamousClinical Trials, Phase III as TopicColorectal NeoplasmsDeoxycytidineDNA MethylationDNA Mismatch RepairFemaleAdaptor Proteins, Signal TransducingCamptothecinCapecitabineDeoxycytidineFluorouracilIrinotecanMLH1 protein, humanMutL Protein Homolog 1Nuclear ProteinsOrganoplatinum CompoundsOxaliplatin

Identifiers

PMID19165197
PMCPMC2634718

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.