Mismatch Repair Status may Predict Response to Adjuvant Chemotherapy in Resectable Pancreatic Ductal Adenocarcinoma (Lynch Syndrome)

Medscape (print version)

 In conclusion, our results show clear differences in the response to adjuvant chemotherapy between the mismatch repair-deficient and -proficient subgroups of pancreatic ductal adenocarcinoma. Since immunohistochemical analysis of mismatch repair system is an accessible and convenient method; this finding has the potential of rapidly changing the treatment algorithm for pancreatic ductal adenocarcinoma. While our results show a robust difference between mismatch repair-deficient and -proficient cohorts with respect to adjuvant chemotherapy, validation of these findings in specimens from previously conducted randomized trials with an untreated control arm is required.
 

Table 1.  Resultant immunophenotypes for the 41 cases determined to be mismatch repair after full section confirmation

MLH1	MSH2	MSH6	PMS2	Prevalence (%)
Intact	Loss	Loss	Intact	64
Loss	Intact	Intact	Loss	25
Intact	Loss	Intact	Intact	5
Loss	Loss	Intact	Loss	2
Loss	Intact	Uninterpretablea	Loss	2
Loss	Uninterpretablea	Intact	Loss	2