Emerging Considerations in the Use of Immune Checkpoint Inhibitors: What Is MSI?

This program will include a discussion of off-label treatment and investigational agents not approved by the FDA for use in the US, and data that were presented in abstract form. These data should be considered preliminary until published in a peer-reviewed journal.

Introduction

NCCN Guidelines for Treatment of dMMR/MSI-H CRC

Background on MMR and MSI

Pathways to Mismatch Repair Deficiency in CRC

Testing Methodologies for dMMR/MSI

Testing Algorithm for MSI

Purpose of MSI Testing: Historical vs Current

Rate Across Solid Tumor Types

Relationship of MSI to Immunologic Response

Phase 2 Study of Pembrolizumab on dMMR or pMMR Metastatic Carcinomas

Phase 2 Study of Pembrolizumab on Different dMMR Tumor Types

Phase 2 Study of Nivolumab Monotherapy in dMMR/MSI-H mCRC: CheckMate 142

PFS and OS in CheckMate 142 Study

Phase 2 Study of Nivolumab Plus Ipilimumab in dMMR/MSI-H mCRC: CheckMate 142

Toxicity of Nivolumab Plus Ipilimumab in dMMR/MSI-H mCRC: CheckMate 142

Phase 1b Study of Atezolizumab Plus Bevacizumab in MSI-H CRC

Chemotherapy Plus Immunotherapy for MSI-H mCRC

MSI-H Tumors Are Heterogeneous

NCCN Guidelines for dMMR/MSI-H Testing

Faculty Suggestions for MSI Testing

Targeted Agents Plus Immunotherapy for MSS Tumors

Atezolizumab ± Cobimetinib vs Regorafenib in MSS CRC: COTEZO IMblaze370

Discussion on Overcoming Therapeutic Resistance

New Therapeutic Approaches

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