In this phase 3, multinational, randomised trial, , progression-free survival outcomes with nivolumab plus ipilimumab were superior to those with chemotherapy in the first-line treatment of MSI-H or dMMR metastatic colorectal cancer.
Grade 3 and 4 treatment-related toxic effects were consistent with the established profiles of each individual drug, and no new safety concerns were identified.
While testing of colorectal cancer tumours for mismatch repair defects has been recommended for years, the majority of patients with abnormal results do not complete the next steps, including genetic testing.
Completed genetic testing would determine whether a patient had Lynch syndrome (LS), a hereditary marker for a higher-than-average predisposition for developing colorectal cancer as well as other cancers, including endometrial and ovarian. Early identification of LS in a patient’s family members has the potential to reduce their cancer risk and mortality, increasing the medical benefit of and thereby ultimately lowering testing costs, the study found.
According to the European Hereditary Tumour Group’s latest position report, LS is now considered an umbrella term for four distinct types of LS: MLH1 syndrome, MSH2syndrome, MSH6 syndrome, and PMS2 syndrome. These syndromes vary with regard to the age of onset of the associated cancers, sex predominance, and cancer incidence rates.
Numerous retrospective studies and several meta-analyses support the increased risk of metachronous CRC, despite segmental resection, recommendations for extended resection remain a subject of debate due to the current absence of prospective studies and randomised trials.
Furthermore, no survival benefit has been demonstrated for extended surgery. A quality-of-life comparison between patients who had undergone segmental resection and patients who had undergone subtotal colectomy did not find a significant difference, but the latter group had poorer functional outcomes
https://academic.oup.com/bjs/article/112/4/znaf061/8113421#google_vignette
Artificial intelligence (AI) has been growing more powerful and accessible, and will increasingly impact many areas, including virtually all aspects of medicine and biomedical research.
Overall, while the precise speed at which AI will continue to change clinical genetics is unclear, as are the overall ramifications for patients, families, clinicians, researchers, and others, it is likely that AI will result in dramatic evolution in clinical genetics.
It will be important for all those involved in clinical genetics to prepare accordingly in order to minimize the risks and maximize benefits related to the use of AI in the field.
But here’s the thing: your anger doesn’t paralise you—it empowers you.
Colectomy is a surgical procedure to remove all or part of your colon. Your colon, part of your large intestine, is a long tubelike organ at the end of your digestive tract. Colectomy may be necessary to treat or prevent diseases and conditions that affect your colon.
There are various types of colectomy operations:
Colectomy surgery usually requires other procedures to reattach the remaining portions of your digestive system and permit waste to leave your body.
https://www.mayoclinic.org/tests-procedures/colectomy/about/pac-20384631
Until relatively recently, the role of a medical oncologist was to weigh up the probable benefits and toxicities of the best available anticancer therapy, and offer professional advice, based on data and experience on the best possible option.
At the threat of being sued if they made a bad decision. Increasingly, the best possible treatment option is not available to medical oncologists as an option.
The best possible treatment option is a question relating to published clinical trial data, international clinical guidelines, and professional opinion, for specific cancer patients.
All of the people currently charged with the responsibility of making reimbursement decisions for new cancer drugs in Ireland have a very difficult job. As difficult as that job is, they do not have to sit in front of someone who has cancer now, requiring a clinical treatment decision.
Tomorrow, again, I will politely ask a drug company for free drug supply.
Michael McCarthy @mccarthymt7 Consultant Medical Oncologist @ University Hospital Galway
This booklet looks at how your lifestyle affects your cancer risk and how to spot cancer early. It includes details on testicular and prostate cancer. It also gives you tips on how to make the best of a visit to your doctor.
https://www.cancer.ie/cancer-information-and-support/cancer-prevention/mens-health
Lynch Syndrome Ireland 