A high tumour mutation load is also associated with mutations in genes for DNA mismatch repair pathways (melanocyte-stimulating hormone (MSH)2, MSH6, MutL homolog 1 (MLH1), post meiotic segregation increased 2 protein (PMS2)), microsatellite instability (MSI), and DNA polymerases (POLE) [29]. This evidence concerns the gene MLH1 and neoplasm.