MSI as a predictive factor for treatment outcome of gastroesophageal adenocarcinoma

• Published in: Cancer treatment reviews Vol. 86; p. 102024
• Main Authors: van Velzen, M.J.M., Derks, S., van Grieken, N.C.T., Haj Mohammad, N., van Laarhoven, H.W.M.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-06-2020
• Subjects: Checkpoint inhibition; Chemotherapy; Gastroesophageal cancer; Immunotherapy; Microsatellite instability; Mismatch repair deficiency; Gastroesophageal cancer; Checkpoint inhibition; Chemotherapy; Mismatch repair deficiency; Microsatellite instability; Immunotherapy
• ISSN: 0305-7372; 1532-1967
• DOI: 10.1016/j.ctrv.2020.102024

•MSI-H has been associated with favorable survival outcomes in gastroesophageal cancer.•In gastroesophageal cancer, MSI-H tumors show resistance to specific cytotoxic drugs.•MSI-H tumors show remarkable and often durable responses to immunotherapy in gastroesophageal cancer.
Gastroesophageal cancers are a major cause of death worldwide and treatment outcomes remain poor. Adequate predictive biomarkers have not been identified.
Microsatellite instability (MSI) as a result of mismatch repair deficiency is present in four to twenty percent of gastroesophageal cancers and has been associated with favorable survival outcomes compared to microsatellite stable tumors. This prognostic advantage may be related to immunosurveillance, which may also explain the favorable response to immune checkpoint inhibition observed in MSI high (MSI-H) tumors. The value of conventional cytotoxic treatment in MSI-H tumors is unclear and results on its efficacy range from detrimental to beneficial effects.
Here the recent data on MSI as a predictive factor for outcome of gastroesophageal cancer treatment is reviewed.