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ESSO 45 | Evaluating the prognostic and predictive roles of MMR/MSI status in colon cancer

Alberto Puccini, MD, Humanitas Research Hospital, Rozzano, Italy, comments on the clinical integration of MMR and MSI status in colon cancer management, highlighting its multifaceted role as a biomarker for chemotherapy resistance in the adjuvant setting, a diagnostic marker for Lynch syndrome, and a predictive factor for immunotherapy benefit. MSI status is the only biomarker currently ready for integration with TNM staging, while other potential biomarkers such as circulating tumor DNA (ctDNA) remain insufficiently validated for clinical implementation. This interview took place at the 2026 European Society of Surgical Oncology (ESSO) Annual Meeting in Madrid, Spain.

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Transcript

I think the only one really ready to is its MMR status...
I think the only one really ready to is its MMR status. We know it’s it’s a biomarker for resistance to chemotherapy in adjuvant setting. It’s diagnostic for Lynch syndrome. So we never had to forget about the suspect of Lynch syndrome in case of colorectal cancer patient with MMR status, DMMR status. And but of course, also now it’s a predictive factor of intense benefit of immunotherapy. And so I think the very the only one really ready to be integrated with TNM is the MSI status. All the others like cdDNA and all the others potential biomarkers are not really ready so far. Right.

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