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What is Microsatelite instability or MSI?
Microsatellites are stretches of nucleotide repeats within the genome that can act as hot spots where errors in DNA replication occur frequently.
Normally, these errors are repaired by the four major mismatch repair (or MMR) proteins.
Sometimes in cancer cells the ability to correct replication errors is disrupted by mutations or methylation silencing of these MMR proteins.
This is called Mismatch Repair deficiency, or MMR, and allows replication errors to accumulate.
Mismatch Repair Deficiency can be a productive marker for immunotherapy
Predictive value of MMR deficiency in stage 4 colon cancer
What is the importance of MSI testing?
Predicting recurrence
Are recurrence scores predictive of outcomes?
Recurrence Scores
How important is MSI status in stage 2 disease?
What is the role of MSI in stage 4 disease?
MSI-High predicts response to immunotherapy
What do you do if you find an MSI-High patient with stage 4 disease and you don't have a trial?
Steps in DNA Mismatch Repair
What is microsatellite instability?
Pathways
Epigenetic changes
How do we differentiate between MSI and MSS?
How can we distinguish between an epigenetic, sporadic MSI-CRC or Andromeda mutation
MSI and survival
MSI and therapy
Do you see MSI in metastases?
What are the clinical implications of the findings?