TY - JOUR
T1 - Clinical implications of microsatellite instability in sporadic colon cancers
AU - Sinicrope, Frank A.
AU - Sargent, Daniel J.
PY - 2009/7
Y1 - 2009/7
N2 - Purpose of review: To review data demonstrating the prognostic and predictive impact of microsatellite instability (MSI) in human colon carcinomas. Recent findings: MSI is a molecular marker of defective DNA mismatch repair that is detected in approximately 15% of sporadic colon cancers. Most, but not all retrospective studies, have shown that colon cancers with MSI have better stage-adjusted survival rates compared with non-MSI tumors. Furthermore, analyses of colon cancers from participants in randomized adjuvant therapy trials have suggested that MSI tumors do not benefit from treatment with 5-fluorouracil. Recent studies, including a pooled analysis, validate prior data demonstrating the prognostic and predictive impact of MSI status in colon cancer. Summary: MSI is a molecular marker that can provide valuable prognostic and predictive information in colon cancer patients. In the appropriate clinical setting, MSI data can be used in clinical decision-making. Specifically, the favorable outcome of stage II colon cancers with MSI indicates that such patients should not receive adjuvant chemotherapy. Although data for stage III colon cancers with MSI suggest a lack of benefit from 5-fluorouracil alone, the benefit of the current standard treatment, 5-fluorouracil, leucovorin, and oxaliplatin, in this subgroup remains unknown and awaits further study.
AB - Purpose of review: To review data demonstrating the prognostic and predictive impact of microsatellite instability (MSI) in human colon carcinomas. Recent findings: MSI is a molecular marker of defective DNA mismatch repair that is detected in approximately 15% of sporadic colon cancers. Most, but not all retrospective studies, have shown that colon cancers with MSI have better stage-adjusted survival rates compared with non-MSI tumors. Furthermore, analyses of colon cancers from participants in randomized adjuvant therapy trials have suggested that MSI tumors do not benefit from treatment with 5-fluorouracil. Recent studies, including a pooled analysis, validate prior data demonstrating the prognostic and predictive impact of MSI status in colon cancer. Summary: MSI is a molecular marker that can provide valuable prognostic and predictive information in colon cancer patients. In the appropriate clinical setting, MSI data can be used in clinical decision-making. Specifically, the favorable outcome of stage II colon cancers with MSI indicates that such patients should not receive adjuvant chemotherapy. Although data for stage III colon cancers with MSI suggest a lack of benefit from 5-fluorouracil alone, the benefit of the current standard treatment, 5-fluorouracil, leucovorin, and oxaliplatin, in this subgroup remains unknown and awaits further study.
KW - Colon cancer
KW - Microsatellite instability
KW - Prediction
KW - Prognosis
UR - http://www.scopus.com/inward/record.url?scp=67650284737&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=67650284737&partnerID=8YFLogxK
U2 - 10.1097/CCO.0b013e32832c94bd
DO - 10.1097/CCO.0b013e32832c94bd
M3 - Review article
C2 - 19444104
AN - SCOPUS:67650284737
SN - 1040-8746
VL - 21
SP - 369
EP - 373
JO - Current Opinion in Oncology
JF - Current Opinion in Oncology
IS - 4
ER -