Evidence map›Paper›PMID 36018445›Full record

ReviewJournal of gastrointestinal cancer2023

Mismatch Repair Screening of Gastrointestinal Cancers: The Impact on Lynch Syndrome Detection and Immunotherapy.

Openshaw M R, Williams J, Foo T, Moss C, Wotherspoon A, Starling N, Kemp Z

Open access · bronzeAbstract readReview
In one paragraph

Review in Journal of gastrointestinal cancer, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.4field-weighted citation impact, top 38% of its field
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Review
  2. Review
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

7 authors at 2 institutions in 1 country.

Openshaw M RRoyal Marsden Hospital, Cancer Genetics Unit, London, UK. mropenshaw@doctors.org.uk.ORCID http://orcid.org/0000-0001-6973-3067
Williams JRoyal Marsden Hospital, Cancer Genetics Unit, London, UK.
Foo TRoyal Marsden Hospital, Cancer Genetics Unit, London, UK.
Moss CRoyal Marsden Hospital, Cancer Genetics Unit, London, UK.
Wotherspoon ARoyal Marsden Hospital, Gastrointestinal Histopathology Unit, London, UK.
Starling NRoyal Marsden Hospital, Gastrointestinal Medical Oncology Unit, London, UK.
Kemp ZRoyal Marsden Hospital, Cancer Genetics Unit, London, UK.
Royal Marsden Hospital · GBQueen Elizabeth Hospital Birmingham · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionMismatch repair immunohistochemistry (MMR IHC) or microsatellite instability (MSI) testing is now routinely performed in patients with colorectal cancer (CRC) to select those requiring Lynch syndrome testing. MMR IHC is also carried out on CRC and upper gastrointestinal (GI) cancers to select patients for immunotherapy. We review the Royal Marsden Hospital's pathway of molecular to germline testing for Lynch syndrome in the context of NICE guidance and the National Test Directory.

methodsWe conducted (i) a retrospective audit of adherence to NICE guidance DG27 for patients diagnosed with CRC March 2017-August 2018 and (ii) a retrospective service evaluation of MMR IHC/Lynch syndrome testing in patients diagnosed with upper GI cancers January 2019-2020.

resultsOf 394 patients with CRC, 346 (87.8%) had MMR IHC testing. Thirty-eight of 346 (10.9%) were MMR deficient (MMR-D) and 5 (1.4%) were found to have pathogenic germline variants causing Lynch syndrome. Of 405 patients with upper GI cancers, 221 (54.6%) had MMR IHC testing. Ten of 221 (4.5%) were MMR-D and 1 (0.5%) had a pathogenic germline variant causing Lynch syndrome. DISCUSSION: This study highlights the small but significant number of patients, with CRC or upper GI cancers, which were caused by Lynch syndrome. It also highlights weaknesses in our testing pathway that limit access to germline testing. As MMR testing increases, it is important that clinicians are aware that patients with MMR-D tumours require reflex somatic testing or referral for germline testing. We have incorporated the guidelines into a pathway for use in clinics and multidisciplinary teams.

Indexed as

Colorectal Neoplasms, Hereditary NonpolyposisGastrointestinal NeoplasmsBrain NeoplasmsColorectal NeoplasmsDNA Mismatch RepairEarly Detection of CancerHumansImmunotherapyMicrosatellite InstabilityNeoplastic Syndromes, HereditaryRetrospective StudiesColorectal cancerGastrointestinal cancerImmunotherapyLynch syndromeMicrosatellite instabilityMismatch repair

Identifiers

PMID36018445
PMCPMC9415243
OpenAlexW4293162208

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.