Abstract
Active specific immunotherapy (ASI) consisting of an autologous tumor cell vaccine given as adjuvant treatment has been shown to improve recurrence-free survival of patients with colon cancer. The aim of the current retrospective study was to investigate whether the beneficial effects of ASI given as adjuvant treatment correlated with microsatellite instability (MSI), which is considered an important biologic determinant of colon cancer. Microsatellite status was assessed on archival tumor material from patients with stage II and III colon cancer. Microsatellite status was next associated with clinical outcome in control and ASI treatment groups using Kaplan-Meier analysis. We identified 162 (83%) microsatellite-stable tumors (MSS) and 34 (17%) MSI tumors. Patients with MSI tumors did well in recurrence-free interval (RFI) as well as disease-specific survival (DSS) irrespective of treatment arm and tumor stage. Patients with MSI tumors had significantly fewer recurrences and prolonged DSS than those with MSS tumors. Patients with MSS Dukes B tumors who received ASI treatment showed a significantly improved recurrence-free survival compared with controls. ASI treatment did not improve recurrence-free interval or DSS for patients with MSS Dukes C tumors. This retrospective study indicated that patients with MSI tumors did well, irrespective of treatment arm and tumor stage. The data also indicate that the clinical benefit, measured as recurrence-free survival, from adjuvant ASI treatment of patients with colon cancer was restricted to patients with MSS Dukes B tumors.
Highlights
Colorectal cancer (CRC) is the third most common cancer worldwide, accounting for more than 1 million cases and 600,000 deaths every year
Patients with microsatellite stable (MSS) Dukes B tumors who received Active specific immunotherapy (ASI) treatment showed a significantly improved recurrence-free survival compared with controls
ASI treatment did not improve recurrence-free interval or disease-specific survival (DSS) for patients with MSS Dukes C tumors. This retrospective study indicated that patients with microsatellite instable (MSI) tumors did well, irrespective of treatment arm and tumor stage
Summary
Colorectal cancer (CRC) is the third most common cancer worldwide, accounting for more than 1 million cases and 600,000 deaths every year. Genomic instability is a key feature of cancer and 2 main types occur in CRC. About 80% to 85% of CRCs show chromosomal instability but have. Authors' Affiliations: Departments of 1Pathology and 2Medical Oncology, VU University Medical Center; 3The Netherlands Cancer Institute, Amsterdam, the Netherlands; 4Department of Pathology, Kennemer Gasthuis, Haarlem, the Netherlands; and 5Department of Medical Oncology, Antwerp University Hospital, Edegem, Belgium. Note: Supplementary data for this article are available at Clinical Cancer Research Online (http://clincancerres.aacrjournals.org/). V.A. de Weger, A.W. Turksma, Q.J.M. Voorham, and Z.
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