Understanding the Importance of Mismatch Repair Deficiency and Microsatellite Instability in Pathology

Course overview

The rapid rate of breakthroughs in immuno-oncology (IO) have created new—and non-intuitive—diagnostic paradigms and testing protocols for cancer. This has led to considerable confusion in the broader pathology and laboratory medicine community about the basic science of IO, as well as a lack of skill in testing and diagnostics associated with IO and immunotherapeutics. ASCP is dedicated to helping pathologists and laboratory professionals develop their core scientific knowledge as well as the testing and diagnostic skill sets associated with IO and immuno-therapeutics to keep up with these scientific advances. This module will discuss the basic biology of mismatch repair deficiency (MMRd) and microsatellite instability (MSI), emphasizing the application of these tests to tumor samples. While these tests have been in place for a considerable time, they have never been more important to oncology patient care. Previously these tests were only applied to patients with a family history of 2 or 3 types of cancers, but now they serve as the gateway for patients to receive immunotherapy, with overall response and complete response rates of 50% and 25% respectively, for 12 different types of cancer. You will learn how the tests were developed, the types and limitations of these tests, and how are currently utilized. Learning Objectives: Upon completion of this module, learners should be able to: • Describe how MMRd and MSI tests were developed • Discuss the limitations of MMRd and MSI tests • Describe the current utilization of MMRd and MSI tests Faculty: Robert A. Anders, MD, PhD Feriyl Bhaijee, MD The American Society for Clinical Pathology is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. Credit Designation Statement The ASCP designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only credit commensurate with the extent of their participation in the activity. These activities also meet MOC Part II Lifelong Learning and Self-Assessment Module (SAMs CME) requirements. ASCP designates these live activities for a maximum of 1.0 CMLE credit. These activities meet CMP and state re-licensure requirements for laboratory personnel. For questions regarding CME credit, please contact ASCP Customer Service at 1-800-267-2727, during normal business hours: Monday through Friday, 8 a.m. to 6 p.m. Eastern Time Method of Participation To complete the activity and receive credit, the participant must complete the online course. CME certificates will be provided on-line. Funded by an independent educational grant from Pfizer/Merck KGaA