Title: Clinicopathological and molecular characteristics of colorectal adenosquamous
carcinoma in an Asian population
Version: 2 Date: 31 Jul 2023
Reviewer's report:
In this article, the authors reported the clinicopathological and molecular characteristics of
colorectal adenosquamouscarcinoma (CASC) in Asian populations. This study revealed that
patients with CASC had a higher rate of dMMR and KRAS mutaions, which was interesting
findings. However, there are several problems as below.
1. As the authors mentioned in the manuscript, the number of patients is very small. Clinical
characteristics and prognosis of CASC has already been described in prior database-based
studies which include a large number of cases. If the authors would like to discuss the clinical
characteristics and prognosis of CASC in Asian populations, the authors should perform multi-
center study with large sample size in Asian region.
2. Although the authors mentioned MMR, HER2, Ki67, KRAS, BRAF, and PIK3CA status of
the patients with CASC, Data on molecular characteristics of CASC are not sufficient. Since
this is a small sample size study, investigating molecular characteristics in more detail may yield
interesting findings. For example, analyzing comprehensive genomic profiles, expressional
status of the ligand of immune checkpoint molecules, tumor microenvironment including tumor
infiltrating immune cells, and so on.
3. If the authors would like to mention the feasibility of targeted therapies including
immunotherapy against SACS, the clinical course, especially treatment response, of the patients
treated with molecular targeted agents or immunotherapy should be described in detail. Although
the authors reported a higher rate of dMMR and KRAS mutations in the patients with CASC,
no findings suggesting the feasibility or efficacy of molecular targeted therapies against CASC
were mentioned in the RESULTS section.
Title: Clinicopathological and molecular characteristics of colorectal adenosquamous
carcinoma in an Asian population
Version: 2 Date: 31 Jul 2023
Reviewer's report:
In this article, the authors reported the clinicopathological and molecular characteristics of
colorectal adenosquamouscarcinoma (CASC) in Asian populations. This study revealed that
patients with CASC had a higher rate of dMMR and KRAS mutaions, which was interesting
findings. However, there are several problems as below.
1. As the authors mentioned in the manuscript, the number of patients is very small. Clinical
characteristics and prognosis of CASC has already been described in prior database-based
studies which include a large number of cases. If the authors would like to discuss the clinical
characteristics and prognosis of CASC in Asian populations, the authors should perform multi-
center study with large sample size in Asian region.
2. Although the authors mentioned MMR, HER2, Ki67, KRAS, BRAF, and PIK3CA status of
the patients with CASC, Data on molecular characteristics of CASC are not sufficient. Since
this is a small sample size study, investigating molecular characteristics in more detail may yield
interesting findings. For example, analyzing comprehensive genomic profiles, expressional
status of the ligand of immune checkpoint molecules, tumor microenvironment including tumor
infiltrating immune cells, and so on.
3. If the authors would like to mention the feasibility of targeted therapies including
immunotherapy against SACS, the clinical course, especially treatment response, of the patients
treated with molecular targeted agents or immunotherapy should be described in detail. Although
the authors reported a higher rate of dMMR and KRAS mutations in the patients with CASC,
no findings suggesting the feasibility or efficacy of molecular targeted therapies against CASC
were mentioned in the RESULTS section.
Please review this paper.
user
Title: Clinicopathological and molecular characteristics of colorectal adenosquamous
carcinoma in an Asian population
Version: 2 Date: 31 Jul 2023
Reviewer's report:
In this article, the authors reported the clinicopathological and molecular characteristics of
colorectal adenosquamouscarcinoma (CASC) in Asian populations. This study revealed that
patients with CASC had a higher rate of dMMR and KRAS mutaions, which was interesting
findings. However, there are several problems as below.
1. As the authors mentioned in the manuscript, the number of patients is very small. Clinical
characteristics and prognosis of CASC has already been described in prior database-based
studies which include a large number of cases. If the authors would like to discuss the clinical
characteristics and prognosis of CASC in Asian populations, the authors should perform multi-
center study with large sample size in Asian region.
2. Although the authors mentioned MMR, HER2, Ki67, KRAS, BRAF, and PIK3CA status of
the patients with CASC, Data on molecular characteristics of CASC are not sufficient. Since
this is a small sample size study, investigating molecular characteristics in more detail may yield
interesting findings. For example, analyzing comprehensive genomic profiles, expressional
status of the ligand of immune checkpoint molecules, tumor microenvironment including tumor
infiltrating immune cells, and so on.
3. If the authors would like to mention the feasibility of targeted therapies including
immunotherapy against SACS, the clinical course, especially treatment response, of the patients
treated with molecular targeted agents or immunotherapy should be described in detail. Although
the authors reported a higher rate of dMMR and KRAS mutations in the patients with CASC,
no findings suggesting the feasibility or efficacy of molecular targeted therapies against CASC
were mentioned in the RESULTS section.
assistant