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MSI-high / dMMR penile squamous cell carcinoma — an uncommon but described biomarker subs...

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

IDRF-PENILE-SCC-MSI-H-ACTIONABILITY
TypeRed flag
Statusreviewed 2026-07-11 | pending_clinical_signoff
DiseasesDIS-PENILE-SCC
SourcesSRC-EAU-PENILE-2024

Red Flag Origin

DefinitionMSI-high / dMMR penile squamous cell carcinoma — an uncommon but described biomarker subset. Opens pembrolizumab (tissue-agnostic MSI-H/dMMR FDA approval, KEYNOTE-158/164 basket) as an alternative to cisplatin-based chemotherapy in metastatic/unresectable disease.
Clinical directionintensify
Categoryhigh-risk-biology
Shifts algorithmALGO-PENILE-SCC-1L

Trigger Logic

{
  "any_of": [
    {
      "finding": "msi_status",
      "value": "MSI-H"
    },
    {
      "finding": "dmmr_status",
      "value": "deficient"
    }
  ],
  "type": "biomarker"
}

Notes

STUB. Drafted for the DIS-PENILE-SCC Phase 1 authoring pass. MSI-H is rare in penile SCC and testing is not routine — this RF fires only when MSI/dMMR testing has actually been performed and returns positive. Mirrors RF-CRC-MSI-H-ACTIONABILITY's trigger/finding-key convention (finding: msi_status / dmmr_status) for consistency across the KB. Requires clinical co-lead signoff before publication (CHARTER §6.1; dev-mode-exempted for draft merge).

Used By

Algorithms

Indications