MSH6 germline loss-of-function in prostate produces dMMR/MSI-H phenotype. Pan- tumor MSI-...
Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.
| ID | BMA-MSH6-GERMLINE-PROSTATE |
|---|---|
| Type | Actionability |
| Status | reviewed 2026-04-27 | pending_clinical_signoff | actionability review required |
| Diseases | DIS-PROSTATE |
| Sources | SRC-ESMO-PROSTATE-2024 SRC-NCCN-PROSTATE-2025 |
Actionability Facts
| Biomarker | BIO-DMMR-IHC |
|---|---|
| Variant | MSH6 germline loss-of-function (dMMR / MSI-H) |
| Disease | DIS-PROSTATE |
| ESCAT tier | IA |
| Recommended combinations | pembrolizumab monotherapy (pan-tumor MSI-H/dMMR, FDA 2017) in mCRPC after NHA/taxane |
| Evidence summary | MSH6 germline loss-of-function in prostate produces dMMR/MSI-H phenotype. Pan- tumor MSI-H ICI eligibility (pembrolizumab per KEYNOTE-158, dostarlimab per GARNET) supersedes tumor-specific lines via tissue-agnostic FDA approval. MSI-H in prostate is rare (~3-5%); pembrolizumab tissue-agnostic applies in mCRPC after standard therapy. |
Notes
Germline MSH6 loss → cascade testing mandatory (Lynch syndrome). Family meets Amsterdam/Bethesda criteria. Pan-tumor MSI-H ICI eligibility supersedes tumor- specific lines.
Used By
No reverse references found in the YAML corpus.