Current Colorectal Cancer Reports

, Volume 11, Issue 5, pp 281–287 | Cite as

Distinctive Tumor Biology of MSI-High Colorectal Cancer

  • Neil Majithia
  • Benjamin R. Kipp
  • Axel GrotheyEmail author
Translational Colorectal Oncology (Y Jiang, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Translational Colorectal Oncology


High-frequency microsatellite instability (MSI-H) accounts for roughly 15 % of all cases of colorectal cancer (CRC) and results from pathogenic mutations or epigenetic changes in mismatch repair (MMR) proteins, primarily MLH1, MSH2, MSH6, and PMS2. These alterations can be inherited, as in the case of Lynch syndrome, or can be acquired sporadically, including cases of epigenetic alteration along crucial regulatory sequences. Cancers that develop in the setting of MSI-H possess a unique clinicopathologic phenotype, with a high degree of mutation resulting in potential recognition by the immune system. These features have directed therapeutic investigation in recent years to involve consideration of immune-stimulating agents, which might exploit the inherent immunogenicity of these tumors.


Colorectal cancer Microsatellite instability Chromosomal instability Mismatch repair deficiency 


Compliance with Ethics Guidelines

Conflict of Interest

Neil Majithia declares that he has no conflict of interest.

Benjamin R. Kipp has received support through a grant from Abbott Molecular, Inc.

Axel Grothey has received support through research grants to the Mayo Foundation from Genentech, Bayer, Eisai, BBI, and Eli Lilly.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Neil Majithia
    • 1
  • Benjamin R. Kipp
    • 2
  • Axel Grothey
    • 3
    Email author
  1. 1.Department of Internal MedicineMayo ClinicRochesterUSA
  2. 2.Department of Laboratory Medicine and PathologyMayo ClinicRochesterUSA
  3. 3.Division of Medical OncologyMayo ClinicRochesterUSA

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