We hypothesize the KISIMA-Ascl2 vaccine should be highly effective in these individuals, as (1) progression of most colon polyps in subjects with Lynch Syndrome occurs via the APC pathway [54] as in Apc+/Min-FCCC mice; (2) early colon lesions in this population exhibit a high mutational burden, which may render these tumors hypersensitive to immunotherapy [22]; and (3) vaccine can be administered to these high-risk individuals prior to tumor development. Here, ASCL2 is linked to Lynch syndrome.