{
  "abstract": "The phase III ATOMIC trial recently showed that adding atezolizumab to standard adjuvant chemotherapy improved disease-free survival (DFS) in patients with mismatch-repair-deficient (dMMR) stage III colon cancer; however, its efficacy in mismatch-repair-proficient (pMMR) disease remains unknown. To address this issue, we reconstructed individual patient-level survival data (IPD) for the centrally confirmed dMMR subgroup, as well as those without centrally confirmed dMMR status (an approximation of the pMMR subgroup) in ATOMIC. The analysis of reconstructed IPD faithfully reproduced the trial’s reported DFS gain by adding atezolizumab to adjuvant chemotherapy in the dMMR subgroup (3-year DFS, 86.2% vs 77.0%; HR, 0.52 (95% CI 0.36 to 0.77)). Intriguingly, DFS was also in favor of the chemo-immunotherapy arm in the approximated pMMR subgroup (3-year DFS, 87.1% vs 77.4%; HR, 0.45 (95% CI 0.16 to 1.27)). The interaction test further demonstrated that treatment effect did not differ by MMR status (Pinteraction=0.808). These findings raise the possibility that adjuvant chemo-immunotherapy may confer benefit even in pMMR stage III colon cancer, which underscores the need for prospective validation in this population.",
  "authors": [
    {
      "affiliations": [
        "Department of Pathology, School of Medicine, Jinan University, Guangzhou, China"
      ],
      "name": "Yu-Tong Chen"
    },
    {
      "affiliations": [
        "Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China"
      ],
      "name": "Ruowei Wang"
    },
    {
      "affiliations": [
        "Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China"
      ],
      "name": "Ying-Ting Situ"
    },
    {
      "affiliations": [
        "Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China"
      ],
      "name": "Wei-Feng Wang"
    },
    {
      "affiliations": [
        "Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China"
      ],
      "name": "Weili Zhang"
    },
    {
      "affiliations": [
        "Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China"
      ],
      "name": "Jun-Zhong Lin"
    },
    {
      "affiliations": [
        "Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China"
      ],
      "name": "Jianhong Peng"
    },
    {
      "affiliations": [
        "Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China"
      ],
      "name": "Zi-Xian Wang"
    }
  ],
  "title": "Adjuvant chemo-immunotherapy shows comparable efficacy among mismatch-repair-deficient and mismatch-repair-proficient stage III colon cancer: an exploratory, reconstructed individual patient-level data analysis",
  "uid": "43d932db-71dc-5dc6-9fc1-e80c5e0b3042"
}