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Cancer Res. 2019 Feb 1;79(3):441-444. doi: 10.1158/0008-5472.CAN-18-2991. Epub 2019 Jan 24.

Is Adjuvant Chemotherapy Efficient in Colon Cancer with High Microsatellite Instability? A Look Towards the Future.

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Department of Medical Oncology, Clinic Hospital of Viña del Mar, Viña del Mar, Chile.
Department of Medical Oncology, Bupa Reñaca Clinic, Viña del Mar, Chile.
Department of Medical Oncology, Ciudad del Mar Clinic, Viña del Mar, Chile.
Graduate School of Arts and Sciences, Tufts University, Medford, Massachusetts.


The high microsatellite instability (MSI-H) is frequently observed in localized colorectal adenocarcinoma. MSI-H is a good prognostic factor in nonmetastatic colon adenocarcinoma. However, MSI-H is not a predictive factor because it is not related with better survival in patients with colon cancer with adjuvant chemotherapy. MSI-H should be a predictive factor because it is associated with a higher expression of enzymes, which are inhibited by cytotoxic agents. Here, we analyze this controversy. We conclude MSI-H is not a predictive factor because the adjuvant therapy based on traditional cytotoxic agents does not act on either immune signaling pathways or BRAF mutation.

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