Journal
FRONTIERS OF MEDICINE
Volume 12, Issue 2, Pages 229-235Publisher
SPRINGER
DOI: 10.1007/s11684-017-0581-0
Keywords
molecular classification; precision medicine; pembrolizumab; PD-1/PD-L1; MSI-H
Categories
Funding
- Chinese National Key Program [2017YFC0908303, 2016YFC1303200]
- National Natural Science Foundation of China [81772505, 81372644]
- Innovation Foundation of Translational Medicine of Shanghai Jiao Tong University School of Medicine [15ZH1002, 15ZH4001, TM201617]
Ask authors/readers for more resources
On May 23, 2017, the US Food and Drug Administration (FDA) approved a treatment for cancer patients with positive microsatellite instability-high (MSI-H) markers or mismatch repair deficient (dMMR) markers. This approach is the first approved tumor treatment using a common biomarker rather than specified tumor locations in the body. FDA previously approved Keytruda for treatment of several types of malignancies, such as metastatic melanoma, metastatic non-small-cell lung cancer, recurrent or metastatic head and neck cancer, refractory Hodgkin lymphoma, and urothelial carcinoma, all of which carry positive programmed death-1/programmed death-ligand 1 biomarkers. Therefore, indications of Keytruda significantly expanded. Several types of malignancies are disclosed by MSI-H status due to dMMR and characterized by increased neoantigen load, which elicits intense host immune response in tumor microenvironment, including portions of colorectal and gastric carcinomas. Currently, biomarker-based patient selection remains a challenge. Pathologists play important roles in evaluating histology and biomarker results and establishing detection methods. Taking gastric cancer as an example, its molecular classification is built on genome abnormalities, but it lacks acceptable clinical characteristics. Pathologists are expected to act as genetic interpreters or genetic translators and build a link between molecular subtypes with tumor histological features. Subsequently, by using their findings, oncologists will carry out targeted therapy based on molecular classification.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available