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Gastrointestinal Cancers • Medical Oncology
Would you consider pembrolizumab treatment in metastatic gastric cancer with absence expression of a single mismatch repair enzyme?
When PDL1 expression is negative, but IHC for mismatch repair expression is consistent with mismatch repair deficiency (MLH2, MSH2, and MSH6 expressed, PMS2 non-expressed), is pembrolizumab appropriate?
Answer from: Medical Oncologist at Academic Institution
The FDA approval of pembrolizumab is for MSI high or mismatch repair deficient (dMMR) tumors regardless of their tissue of origin. Therefore, if you have MSI high or MMR deficient patients, there is no reason to look for other biomarkers such as PDL1.PDL1 is to some extent linked to benefit of PD1 i...
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