Also known as: MSI-H
Four biomarkers—MMR, HER2, PD-L1, and Claudin 18.2—are now validated for advanced esophageal cancer, guiding immunotherapy and targeted treatment decisions. Checkpoint inhibitors show clear benefit in MSI-H and PD-L1-positive subgroups, with long-term survival observed. NCCN guidelines recommend broad testing to personalize therapy.
Dual immunotherapy allowed 70.6% of MSI-H gastric cancer patients to avoid surgery in the INFINITY trial. German off-label immunotherapy shows 20-25% response rates, requiring careful patient selection.
A rectal cancer study found hypofractionated radiotherapy increased ISG15+MHC-I+ neutrophils with antigen-presenting capabilities. The report linked the effect to IFN-α/NOD1 signaling and improved anti-PD-1 responses in models.
Atezolizumab combined with chemotherapy shows significant benefits in dMMR/MSI-H colorectal cancer. In stage III disease, the ATOMIC trial demonstrated improved 3-year DFS (86.3% vs 76.2%) with atezolizumab plus mFOLFOX6. For metastatic disease, the COMMIT trial showed superior PFS (24.5 vs 5.3 months) with atezolizumab, bevacizumab, and FOLFOX versus atezolizumab monotherapy.
Researchers at Stony Brook University developed an oral vaccine using modified Listeria monocytogenes that generates anti-tumor immune responses in the gut and significantly improves colorectal cancer control when combined with checkpoint inhibitors.
