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MSI-H / dMMR

Good Prognosis
15.00% Prevalence Level 1 Immunotherapy Biomarkers
Actionable Target
FDA-approved targeted therapies or strong clinical trial evidence available
Genes Involved
MLH1 MSH2 MSH6 PMS2
Treatment Implications

FIRST-LINE: Nivolumab + Ipilimumab (CheckMate-8HW, ORR 71%, 24mo PFS 72%) OR Pembrolizumab (KEYNOTE-177). CheckMate-8HW showed superiority over chemotherapy. Later lines: Nivolumab, Pembrolizumab, Dostarlimab.

Recommended Treatments
Nivolumab + Ipilimumab (first-line)
Pembrolizumab (first-line)
Dostarlimab
Treatments to Avoid
5-FU monotherapy
Study References

CheckMate-8HW (PMID: 39602630), KEYNOTE-177 (PMID: 32511132)

Key Statistics
15.00%
Prevalence in CRC
Yes
Targetable
Clinical Notes
Updated 2024: CheckMate-8HW established Nivo+Ipi as preferred first-line for MSI-H mCRC. ORR 71% vs 14% chemo, 24mo PFS 72% vs 14%. Prevalence: ~15% all stages, ~4-5% metastatic. Test all mCRC at diagnosis.
Information

Category: Immunotherapy Biomarkers

Evidence Level: Level 1

Last Updated: Dec 21, 2025

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Medical Disclaimer: This information is for educational purposes only and should not replace professional medical advice. Always consult with your oncologist for personalized treatment decisions based on your specific situation.