Yelena Y. Janjigian, MD, Reviews MSI as a Biomarker in for Localized Gastric Cancer


Yelena Y. Janjigian, MD, spoke about which biomarkers were most predictive for treatment of localized gastric cancer.

At the 2022 International Gastric Cancer Conference, Yelena Y. Janjigian, MD, chief of Gastrointestinal Oncology Service at Memorial Sloan Kettering Cancer Center, spoke with CancerNetwork® about microsatellite instability (MSI) as a biomarker for patients with localized gastric cancer and how it may be effective when deciding on treatment options.


For localized therapy, the most important biomarker that we could check—and it’s critical, even though that’s a rare biomarker—is microsatellite instability, or the MSI-high population. We know that these patients tend to do very well perhaps with surgery alone or even potentially with immunotherapy and then surgery. We also know, definitively, that immunotherapy is important in those patients with stage IV disease. Whether it will have a definitive foothold in the perioperative setting is still to be determined. What we also know is that those patients’ tumors tend to be chemotherapy resistant. You may harm your patient, as a surgeon, if you don’t know what their MSI status is, and then refer them to preoperative therapy. Data from the MAGIC study shows that peri-operative [epirubicin-based] therapy harms those patients. There are plenty of data to suggest that immunotherapy helps, but chemotherapy probably harms or is neutral. There’s a suggestion that chemotherapy in adjuvant setting may be neutral, but in the preoperative setting it’s harmful.


Cunningham D, Allum WH, Stenning SP, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med. 2006;355(1):11-20. doi:10.1056/NEJMoa055531

Related Videos
Although no responses were observed in 11 patients receiving abemaciclib monotherapy, combination therapies with abemaciclib may offer clinical benefit.
Findings show no difference in overall survival between various treatments for metastatic RCC previously managed with immunotherapy and TKIs.
An epigenomic profiling approach may help pick up the entire tumor burden, thereby assisting with detecting sarcomatoid features in those with RCC.
Future meetings may address how immunotherapy, bispecific agents, and CAR T-cell therapies can further impact the AML treatment paradigm.
Treatment with revumenib appeared to demonstrate efficacy among patients with KMT2A-rearranged acute leukemia in the phase 2 AUGMENT-101 study.
Advocacy groups such as Cancer Support Community and the Leukemia & Lymphoma Society may help support patients with CML undergoing treatment.
Paolo Tarantino, MD, discusses the potential utility of agents such as datopotamab deruxtecan and enfortumab vedotin in patients with breast cancer.
Paolo Tarantino, MD, highlights strategies related to screening and multidisciplinary collaboration for managing ILD in patients who receive T-DXd.
Data from the REVEAL study affirm elevated white blood cell counts and higher variant allele frequency as risk factors for progression in polycythemia vera.
Additional analyses of patient-reported outcomes and MRD status in the QuANTUM-First trial are also ongoing, says Harry P. Erba, MD, PhD.
Related Content