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    Association details:
    Biomarker:MSI-H/dMMR
    Cancer:Gallbladder Cancer
    Drug:Keytruda (pembrolizumab) (PD1 inhibitor)
    Direction:Sensitive
    Evidence:
    Evidence Level:
    Sensitive: C1 - Off-label
      (Approved for Small Intestinal Carcinoma)
    New
    Title:

    European Commission Approves Merck’s KEYTRUDA® (pembrolizumab) for Patients With Microsatellite Instability-High (MSI-H) or Deficient Mismatch Repair (dMMR) Tumors in Five Different Types of Cancer

    Excerpt:
    Merck...announced that the European Commission has approved KEYTRUDA, Merck’s anti-PD-1 therapy, as monotherapy for the treatment of microsatellite instability-high (MSI-H) or deficient mismatch repair (dMMR) tumors in adults with...unresectable or metastatic gastric, small intestine or biliary cancer, who have disease progression on or following at least one prior therapy.
    Evidence Level:
    Sensitive: C2 – Inclusion Criteria
    New
    Source:
    clinicaltrials.gov
    Title:

    Study of Pembrolizumab (MK-3475) in Participants With Advanced Solid Tumors (MK-3475-158/KEYNOTE-158)

    Excerpt:
    ...- Any advanced solid tumor, with the exception of colorectal carcinoma (CRC), which is Microsatellite Instability (MSI)-High (MSI-H) OR...
    Trial ID:
    KEYNOTE-158
    Evidence Level:
    Sensitive: C4 – Case Studies
    Source:
    CAP 2020
    Title:

    The Misaligned Clinical Course Due to a Missed Mismatch Repair–Deficient Gallbladder Carcinoma

    Published date:
    10/14/2020
    Excerpt:
    We introduce an initially missed D-MMR gallbladder carcinoma in a 50-year-old woman... immunostaining uncovered loss of MSH6 and MSH2 but retained MLH1 and PMS2 in the tumor (Figure 292). Molecular testing confirmed D-MMR and further detected KRAS G12D mutation. These findings led to pembrolizumab-based management and after 6 cycles, imaging studies confirmed the residual tumor had disappeared. The patient remains disease free 1 year later.
    DOI:
    https://doi.org/10.5858/arpa.2020-0991-AB