Universität zu Köln

Rueschoff, Josef, Baretton, Gustavo, Blaeker, Hendrik, Dietmaier, Wolfgang, Dietel, Manfred, Hartmann, Arndt, Horn, Lars-Christian, Joehrens, Korinna, Kirchner, Thomas, Knuchel, Ruth, Mayr, Doris, Merkelbach-Bruse, Sabine, Schildhaus, Hans-Ulrich, Schirmacher, Peter, Tiemann, Markus, Tiemann, Katharina, Weichert, Wilko and Buettner, Reinhard (2021). MSI testing What is new? What should be considered? German version. Pathologe, 42 (4). S. 414 - 424. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1432-1963

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Abstract

Based on new trial data regarding immune checkpoint inhibitors (ICIs), the detection of high-grade microsatellite instability (MSI-H) or underlying deficient mismatch repair protein (dMMR) is now becoming increasingly important for predicting treatment response. For the first time, a PD-1 ICI (pembrolizumab) has been approved by the European Medicines Agency (EMA) for first-line treatment of advanced (stage IV) dMMR/MSI-H colorectal cancer (CRC). Further indications, such as dMMR/MSI-H endometrial carcinoma (EC), have already succeeded (Dostarlimab, 2nd line treatment) and others are expected to follow before the end of 2021. The question of optimal testing in routine diagnostics should therefore be re-evaluated. Based on a consideration of the strengths and weaknesses of the widely available methods (immunohistochemistry and PCR), a test algorithm is proposed that allows quality assured, reliable, and cost-effective dMMR/MSI-H testing. For CRC and EC, testing is therefore already possible at the primary diagnosis stage, in line with international recommendations (NICE, NCCN). The clinician is therefore enabled from the outset to consider not only the predictive but also the prognostic and predispositional implications of such a test when counseling patients and formulating treatment recommendations. As a basis for quality assurance, participation in interlaboratory comparisons and continuous documentation of results (e.g., QuIP Monitor) are strongly recommended.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Rueschoff, Josef UNSPECIFIED UNSPECIFIED UNSPECIFIED Baretton, Gustavo UNSPECIFIED UNSPECIFIED UNSPECIFIED Blaeker, Hendrik UNSPECIFIED UNSPECIFIED UNSPECIFIED Dietmaier, Wolfgang UNSPECIFIED UNSPECIFIED UNSPECIFIED Dietel, Manfred UNSPECIFIED UNSPECIFIED UNSPECIFIED Hartmann, Arndt UNSPECIFIED UNSPECIFIED UNSPECIFIED Horn, Lars-Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Joehrens, Korinna UNSPECIFIED UNSPECIFIED UNSPECIFIED Kirchner, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Knuchel, Ruth UNSPECIFIED UNSPECIFIED UNSPECIFIED Mayr, Doris UNSPECIFIED UNSPECIFIED UNSPECIFIED Merkelbach-Bruse, Sabine UNSPECIFIED UNSPECIFIED UNSPECIFIED Schildhaus, Hans-Ulrich UNSPECIFIED UNSPECIFIED UNSPECIFIED Schirmacher, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Tiemann, Markus UNSPECIFIED UNSPECIFIED UNSPECIFIED Tiemann, Katharina UNSPECIFIED UNSPECIFIED UNSPECIFIED Weichert, Wilko UNSPECIFIED UNSPECIFIED UNSPECIFIED Buettner, Reinhard UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-603182
DOI:	10.1007/s00292-021-00944-7
Journal or Publication Title:	Pathologe
Volume:	42
Number:	4
Page Range:	S. 414 - 424
Date:	2021
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1432-1963
Language:	German
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language MISMATCH; IMMUNOHISTOCHEMISTRY; DIAGNOSIS; TUMORS; CARCINOMA; PROTEIN Multiple languages Pathology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/60318