{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T19:45:54Z","timestamp":1791834354705,"version":"4.3.4"},"reference-count":57,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J Surg Pathol"],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      The DNA mismatch repair (MMR) pathway preserves genomic stability by correcting replication errors, with\n                      <jats:italic toggle=\"yes\">MLH1<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">MSH2<\/jats:italic>\n                      playing central roles in mismatch recognition and repair. Loss of these proteins results in microsatellite instability, increased mutational burden, and genomic instability, contributing to prostate cancer development and progression. Emerging evidence suggests that\n                      <jats:italic toggle=\"yes\">MMR<\/jats:italic>\n                      alterations define a distinct and clinically relevant subset of prostate cancer.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A narrative literature review was performed using PubMed, Scopus, and Google Scholar databases. Articles published in English up to January 2026 were screened using combinations of the keywords \u201cprostate cancer,\u201d \u201cmismatch repair,\u201d \u201cMLH1,\u201d \u201cMSH2,\u201d \u201cmicrosatellite instability,\u201d and \u201cDNA repair.\u201d Original studies, clinical trials, genomic analyses and relevant review articles focusing on MMR alterations in prostate cancer were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Germline MMR mutations are uncommon in prostate cancer; however, somatic alterations, particularly involving\n                      <jats:italic toggle=\"yes\">MSH2<\/jats:italic>\n                      and less frequently\n                      <jats:italic toggle=\"yes\">MLH<\/jats:italic>\n                      1, are enriched in advanced and metastatic disease. MMR-deficient tumors demonstrate high tumor mutational burden, increased neoantigen formation, enhanced immune infiltration, and upregulation of immune checkpoint molecules such as\n                      <jats:italic toggle=\"yes\">PD-L1<\/jats:italic>\n                      , contributing to responsiveness to immunotherapy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">MLH1<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">MSH2<\/jats:italic>\n                      alterations define a clinically significant molecular subtype of prostate cancer. Identification of MMR deficiency can guide immunotherapy selection, supporting the integration of molecular profiling into routine clinical practice.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10668969261483643","type":"journal-article","created":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T12:28:22Z","timestamp":1791548902000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Mismatch Repair Pathway,\n                    <i>MLH1, MSH2<\/i>\n                    and Mutations in Prostate Cancer"],"prefix":"10.1177","author":[{"family":"Himanshu","sequence":"first","affiliation":[{"name":"All India Institute of Medical Sciences, New Delhi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0660-9939","authenticated-orcid":false,"given":"Md Ali","family":"Osama","sequence":"additional","affiliation":[{"name":"All India 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