Management of non-colorectal digestive cancers with microsatellite instability

Mojun Zhu, Zhaohui Jin, Joleen M. Hubbard

Research output: Contribution to journalReview articlepeer-review

Abstract

Microsatellite instability (MSI) is a hallmark of genetic predisposition to DNA damage. It arises from either germline or somatic events leading to impaired function of the mismatch repair system. It can be detected via genetic sequencing or immunohistochemistry with relatively high concordance rates. The presence of MSI in a tumor reflects a high neoantigen load and predicts favorable treatment response to immune checkpoint inhibitors (ICIs). In gastrointestinal cancers, MSI is a predictive biomarker for ICIs with potential prognostic impact but its clinical utility varies widely depending on tumor type. This may be explained by the complexity of tumor microenvironment as highlighted by recent translational studies. In this review, we will discuss the predictive and prognostic value of MSI status in non-colorectal cancers of the digestive system, important clinical trials involving ICIs and potential strategies to overcome resistance to immunotherapy.

Original languageEnglish (US)
Article number651
Pages (from-to)1-21
Number of pages21
JournalCancers
Volume13
Issue number4
DOIs
StatePublished - Feb 2 2021

Keywords

  • Checkpoint
  • Gastrointestinal cancer
  • Microsatellite instability

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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