Target intelligence / Profile preview

DNA mismatch repair pathway (MMR pathway)

Target
MMR pathway
Molecular classification
Other (DNA repair pathway, not a single molecular entity such as \"enzyme\" or \"receptor\")
01

Overview

The DNA mismatch repair pathway is a highly conserved multi-protein DNA repair mechanism that detects and corrects errors resulting from DNA replication, primarily base-base mismatches and small insertion-deletion loops. This pathway includes proteins such as MutS homologs (MSH2, MSH6, MSH3) that recognize DNA mismatches, and MutL homologs (MLH1, PMS2, PMS1, MLH3) that coordinate and execute excision and resynthesis of erroneous DNA segments. Proper function of the pathway is essential for preventing mutations and suppressing tumorigenesis, as loss or dysfunction leads to increased cancer risk and is a key feature of some hereditary cancer syndromes like Lynch syndrome.

Other names
Mismatch repair pathwayMMR systemPost-replicative mismatch repair pathwayDNA MMR
02

Mechanism of action

For relevant drugs: Synthetic lethality in MMR-deficient tumors, or increased immune recognition due to high mutational burden in MMR-deficient cancers targeted by immunotherapy

03

Biological functions

Maintenance of genomic stabilityDNA repairMutation preventionSuppression of tumorigenesisCorrection of DNA replication errorsDNA damage response
04

Disease associations

Cancer (especially colorectal, endometrial, and other Lynch syndrome–associated cancers)Neurodegenerative and neuromuscular diseases (due to trinucleotide repeat expansions)
05

Safety considerations

Deficiency (not inhibition) in MMR is associated with increased mutation rates, cancer predisposition, and therapy resistance in some tumorsNo direct safety concerns for targeting the pathway, since it is not a direct druggable target; DNA repair pathway inhibition in normal cells could cause genomic instability and toxicity
06

Interacting drugs

Immune checkpoint inhibitors (e.g., pembrolizumab and nivolumab; these target cancers with deficient MMR, not the pathway directly)

1 more in the full profile.

07

Biomarkers

Microsatellite instability (MSI)Loss of expression of MMR proteins (MSH2, MSH6, MLH1, PMS2) by immunohistochemistryTumor mutational burden (TMB) in the context of immunotherapy

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