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Int J Colorectal Dis. 2007 Jul;22(7):739-48. Epub 2006 Nov 16.

The role of chemotherapy in microsatellite unstable (MSI-H) colorectal cancer.

Author information

1
Department of Cancer Genetics, Kolling Institute of Medical Research, Royal North Shore Hospital and University of Sydney, St. Leonards, NSW, 2065, Australia. janindra@bigpond.com

Abstract

INTRODUCTION:

High-frequency microsatellite instability (MSI-H) is an alternate pathway of colorectal carcinogenesis, which accounts for 15% of all sporadic colorectal cancers. These tumours arise from mutations in the DNA mismatch repair system and thus have different responses to chemotherapeutic agents compared to microsatellite stable (MSS) cancers.

OBJECTIVE:

This review aims to summarise the available literature on the responses to chemotherapy in MSI-H colorectal cancer (CRC).

RESULTS AND DISCUSSION:

5 Fluorouracil (5FU) is commonly used as a chemotherapeutic agent in colon cancer and in vitro evidence shows reduced response to 5FU in MSI-H CRC. The clinical evidence is conflicting but favours a reduced response to 5FU in MSI-H CRC. Several newer agents such as COX-2 inhibitors and irinotecan are also reviewed.

CONCLUSION:

Available evidence suggests that MSI-H CRC have different behaviour patterns and response to chemotherapy compared with MSS CRC.

PMID:
17109103
DOI:
10.1007/s00384-006-0228-0
[Indexed for MEDLINE]

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