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Management of Microsatellite Instability High (MSI-H) Gastroesophageal Adenocarcinoma.
BACKGROUND: Gastroesophageal cancer is a major cause of cancer-related mortality worldwide. Treatment of both early stage and advanced disease remains highly reliant on cytotoxic chemotherapy. About 4-24% of gastroesophageal cancers are microsatellite instability high (MSI-H). The MSI-H subtype is associated with favorable prognosis, resistance to cytotoxic chemotherapy, and sensitivity to immune checkpoint inhibitors (ICI). Recent studies have demonstrated promising activity of ICIs in the MSI-H subtype, resulting in fundamental changes in the management of MSI-H gastroesophageal adenocarcinoma. PURPOSE: In this review, we discuss the prevalence, characteristics, prognosis, and management of MSI-H gastroesophageal adenocarcinoma, with a focus on recent and ongoing studies that have changed the landscape of treatment for the MSI-H subtype. We also discuss current challenges in the management of resectable and advanced MSI-H gastroesophageal cancer, including the need for more accurate biomarkers of response to ICI therapy.
Duke Scholars
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Related Subject Headings
- Stomach Neoplasms
- Prognosis
- Microsatellite Instability
- Immune Checkpoint Inhibitors
- Humans
- Gastroenterology & Hepatology
- Esophagogastric Junction
- Esophageal Neoplasms
- Biomarkers, Tumor
- Adenocarcinoma
Citation
![Journal cover image](https://secure.syndetics.com/index.aspx?isbn=/lc.gif&issn=1941-6636&client=dukeuniv)
Published In
DOI
EISSN
Publication Date
Volume
Issue
Start / End Page
Location
Related Subject Headings
- Stomach Neoplasms
- Prognosis
- Microsatellite Instability
- Immune Checkpoint Inhibitors
- Humans
- Gastroenterology & Hepatology
- Esophagogastric Junction
- Esophageal Neoplasms
- Biomarkers, Tumor
- Adenocarcinoma