Management of Non-Colorectal Digestive Cancers with Microsatellite Instability

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 rate...

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Bibliographic Details
Published in:Cancers 2021-02, Vol.13 (4), p.651
Main Authors: Zhu, Mojun, Jin, Zhaohui, Hubbard, Joleen M
Format: Article
Language:English
Subjects:
Antigens
Biomarkers
Cancer therapies
Chemotherapy
Clinical trials
Deoxyribonucleic acid
DNA
DNA damage
DNA methylation
Epstein-Barr virus
FDA approval
Gastric cancer
Immune checkpoint inhibitors
Immune system
Immunohistochemistry
Immunotherapy
Lymphocytes
Medical prognosis
Metastasis
Microsatellite instability
Mismatch repair
Neoantigens
Proteins
Review
Tumor microenvironment
Tumors
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Description
Summary: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.
ISSN:2072-6694
2072-6694
DOI:10.3390/cancers13040651