2019
DOI: 10.1093/annonc/mdz116
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ESMO recommendations on microsatellite instability testing for immunotherapy in cancer, and its relationship with PD-1/PD-L1 expression and tumour mutational burden: a systematic review-based approach

Abstract: Background: Cancers with a defective DNA mismatch repair (dMMR) system contain thousands of mutations most frequently located in monomorphic microsatellites and are thereby defined as having microsatellite instability (MSI). Therefore, MSI is a marker of dMMR. MSI/dMMR can be identified using immunohistochemistry to detect loss of MMR proteins and/or molecular tests to show microsatellite alterations. Together with tumour mutational burden (TMB) and PD-1/PD-L1 expression, it plays a role as a predictive biomar… Show more

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Cited by 727 publications
(739 citation statements)
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“…In fact, 14 different PCRs were described, with only 6 studies (26% of all PCR-based studies) using the standardised NCI/MSI PCR markers. 4 A similar situation was observed for IHC, with four different types of analyses and only seven studies (53.8%) using the standardised antibodies.…”
Section: Resultssupporting
confidence: 60%
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“…In fact, 14 different PCRs were described, with only 6 studies (26% of all PCR-based studies) using the standardised NCI/MSI PCR markers. 4 A similar situation was observed for IHC, with four different types of analyses and only seven studies (53.8%) using the standardised antibodies.…”
Section: Resultssupporting
confidence: 60%
“…52 However, due to the strong association of these two PDAC variants with MSI/dMMR, for cases of medullary and mucinous/colloid histology, the final pathology report should be integrated with the assessment of MSI/dMMR status. This should be performed using IHC as first-line analysis, also following existing guidelines, 4 and, only in the case of doubtful or not reliable IHC results, MSI-based PCR should be executed. Considering the different advantages and limitations of the methods of MSI testing in PDAC (which have been summarised in table 2), NGS is recommended as first-line analysis in the case of limited tissue, and in the context of precision oncology.…”
Section: Discussionmentioning
confidence: 99%
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