Remission in Every Patient
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Yea this publication in the nejm has been making the rounds. The real question is, does a complete response translate to better survival. That’s been shown to be true in melanoma and breast, not yet in colorectal. While a complete path response (meaning at surgery no viable tumor) is obviously a good thing, there is no guarantee that means there will be less distant recurrence (meaning metastases) and longer survival. Only long term follow up of a number of years will show that but it’s encouraging.
Although this is really a small subset of the rectal cancer population, the ones characterized as dMMR/MSI high (about 15% tops), and we know these tumors are immunotherapy sensitive, what makes this study unique, something u don’t see everyday, is 100% complete response. I think that’s why the New England picked up on it even though it’s a small number of patients (12, don’t know why the nyt reported 18) with a short follow up.
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ASCO (American Society of Clinical Oncology) is meeting right now - so there will be a lot of exciting stories out there.
@kluurs said in Remission in Every Patient:
ASCO (American Society of Clinical Oncology) is meeting right now - so there will be a lot of exciting stories out there.
I often went to ASCO (and met up with Dr G) in the past, always in Chicago. I’ve been forced for professional reasons to go to more surgical conferences and that doesn’t leave time for the medical ones so much. In October I go to Bordeaux France for the European society of surgical oncology meeting and the following March to Boston for the American counterpart meeting. It’s because of some professional obligations which make my presence there somewhat mandatory.
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Yea this publication in the nejm has been making the rounds. The real question is, does a complete response translate to better survival. That’s been shown to be true in melanoma and breast, not yet in colorectal. While a complete path response (meaning at surgery no viable tumor) is obviously a good thing, there is no guarantee that means there will be less distant recurrence (meaning metastases) and longer survival. Only long term follow up of a number of years will show that but it’s encouraging.
Although this is really a small subset of the rectal cancer population, the ones characterized as dMMR/MSI high (about 15% tops), and we know these tumors are immunotherapy sensitive, what makes this study unique, something u don’t see everyday, is 100% complete response. I think that’s why the New England picked up on it even though it’s a small number of patients (12, don’t know why the nyt reported 18) with a short follow up.
@bachophile thanks for your input. As I re-read the article, or at least the abstract, it also became apparent to me that remission≠cure and survival.
I was not aware, because this is way, way, out of my wheelhouse that this tumor is immunosensitive.
Nevertheless, despite the small group, it's encouraging.
"Now look here, you Baltic gas passer... " - Mik, 6/14/08
The saying, "Lite is just one damn thing after another," is a gross understatement. The damn things overlap.
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@kluurs said in Remission in Every Patient:
ASCO (American Society of Clinical Oncology) is meeting right now - so there will be a lot of exciting stories out there.
I often went to ASCO (and met up with Dr G) in the past, always in Chicago. I’ve been forced for professional reasons to go to more surgical conferences and that doesn’t leave time for the medical ones so much. In October I go to Bordeaux France for the European society of surgical oncology meeting and the following March to Boston for the American counterpart meeting. It’s because of some professional obligations which make my presence there somewhat mandatory.
@bachophile said in Remission in Every Patient:
@kluurs said in Remission in Every Patient:
ASCO (American Society of Clinical Oncology) is meeting right now - so there will be a lot of exciting stories out there.
I often went to ASCO (and met up with Dr G) in the past, always in Chicago. I’ve been forced for professional reasons to go to more surgical conferences and that doesn’t leave time for the medical ones so much. In October I go to Bordeaux France for the European society of surgical oncology meeting and the following March to Boston for the American counterpart meeting. It’s because of some professional obligations which make my presence there somewhat mandatory.
Well, dammit, I guess if you have to suffer for your profession, Bordeaux might not be too bad. Boston, well...
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Warning: I post things that interest me. Read and comment at your own discretion.
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@bachophile thanks for your input. As I re-read the article, or at least the abstract, it also became apparent to me that remission≠cure and survival.
I was not aware, because this is way, way, out of my wheelhouse that this tumor is immunosensitive.
Nevertheless, despite the small group, it's encouraging.
@George-K also to be very honest, the times use of the term remission is not accurate. Remission is usually reserved for hematoligcal malignancies like leukemia. Solid tumors are judged on pathological response to therapy. Complete response. Partial response. No response. Progressive disease.
It’s maybe semantics but to my ear sounds foreign. Because as u say, this is exactly my wheelhouse. Rectal tumors don’t go into remission. They either respond or don’t.
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@bachophile said in Remission in Every Patient:
@kluurs said in Remission in Every Patient:
ASCO (American Society of Clinical Oncology) is meeting right now - so there will be a lot of exciting stories out there.
I often went to ASCO (and met up with Dr G) in the past, always in Chicago. I’ve been forced for professional reasons to go to more surgical conferences and that doesn’t leave time for the medical ones so much. In October I go to Bordeaux France for the European society of surgical oncology meeting and the following March to Boston for the American counterpart meeting. It’s because of some professional obligations which make my presence there somewhat mandatory.
Well, dammit, I guess if you have to suffer for your profession, Bordeaux might not be too bad. Boston, well...
@Jolly I don’t mind Boston. But it’s not Bordeaux.
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