A 100% Complete Response Rate??? I breakdown Dostarlimab in MSI-H Stage II/III Rectal | ASCO Update
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- čas přidán 25. 07. 2024
- Vinay Prasad, MD MPH; Physician & Associate Professor
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An excellent, thought provoking presentation! Thank you.
Thank you! Sounds like a good plan to me. Very informative.
Awesome hearing your thoughts 💭 I’m an emergency physician and unfortunately I’m the one who finds these cancers when people come into ED. It’s nice to see the breakdown and analysis. I think that paragraph you had issues with is very valid but it was an implant to get mainstream using words like “ cure for cancer” It’s a nice start and a hopeful beginning. Thanks for your content. Your Covid coverage was awesome.
Really?
Glad you reviewed this. Was waiting for your take on it.
Informative. I love the way you break things down.
"when I don't have a problem with something, I don't have a problem with it."
Optimistic about this one - and man do we need something good to come along after these past 2 years!
Thank you for all this medical research review magic!!!
I can hear you just fine
Loved hearing your thoughts on the rectal cancer treatment. Curious what % of cancers would be susceptible to this drug.
These were 12 very specific patients I think more studies should be done but people are already jumping to conclusions that this would work for every patient with rectal cancer and with every other cancer.
They say in the study itself that it only would work in 10-15% of rectal cancer patients - the ones with the specific mutation they targeted
It’s very promising because it’s not 1 or 2 but all 12 different people that have been participating all have been cured and that is not a coincidence.
@@alexdevcamp no they say that treatment has been made for this specific mutation but now since they know how to cure it, more studies on other mutations will follow.
Nice video. The parachute analogy may be abused for some conditions, but I think when the magnitude of the effect is so large compared to the alternative, small sample and wide CIs are not that important, and to me it becomes almost obvious that a therapy should be followed with a phase 4 study (I think that’s what you are suggesting) while becoming standard of care for the condition with met criteria. The problem I think is that we tend to assess therapies in the medical context without much consideration of the human and financial cost to society. An old teacher used to say ‘think like a patient, don’t think like a doctor’...
OMG it's VP approved! Thanks for your insights doc!
As a myeloma patient I appreciate your close scrutiny of drugs and trials results.
Love your proposed study design! Wish there were financial incentives for someone to actually do it.
Love your content. This is wonderful. I’m not sure you look into rheumatology in any way, but in the future, I’d love more information on the drugs used in this area. My reasoning, I had juvenile RA since 10 years old. Taken nearly 10 different drugs for it, nearly 4 different standards of care (I’d say). The last medication (Biologic also used in cancer treatment) I was on, I took for a couple years, and stopped after I switched careers and didn’t want to take time off to go get my infusions (silly, I know). Either way, since then, my RA has never come back. It’s been 6 years. My RA nurse may have suggested that she’s heard it from other patients using the same med. I’m hesitant to say I’m cured, but it’s been an amazing 6 years.
That's fantastic!
Happy for you! What’s the name of the last medication (infusion)? Did you change your diet at all? Thanks in advance!
You're look dapper!
i love the timing on 'that arm is closed.' black screen.
Historic. This will be in the textbooks for generations
The RCT you described is a great way to see if this treatment can become the new "standard of care." The idea is that you randomize this treatment against current "standard of care" so everyone gets at least the standard of care at minimum. Yes this treatment seems very promising but you really want to see this in much larger population.
Wouldnt it be quicker and cheaper to just test the parachute idea first? Instead of 12 people now do 1200 people with the same parameters and if you get your 100% then BINGO, heck a you will get a percentage at least then compare that to the usual
@@daezeechayne462 That would not be the way to do the study. You need to do comparisons at the same time.
I'm thankful medical professionals are researching ways to help our own immunity system fight cancer rather than relying SOLELY on "slash & burn" treatments. I acknowledge chemo/radiation have their place in treatment but the medical field has been fixated on them almost exclusively. Big Pharma inffluence maybe? And yes, this is written by a common laymanbut I was able to follow Dr. Mobeen Syed's explanation of the method of action of the drug. (Dr. Been Medical Lectures.)
I believe you are a great communicator of medicine. The 1980's drug dealer look is interesting. Keep it for a minute to see if people enjoy it or not.
Speaking of Colon Cancer, I had surgery in December of 2013 and to this day have had stitches coming out of me. Started with a blister like spot when lanced blood and a two inch stitch. I have had to apply gauze everyday except 3 weeks since the surgery. Had the surgery at the Mayo Clinic in Rochester Minnesota. Called them and the answer I had gotten wasn't very professional. I wanted to know how many stitches were put in or how many packages of material was used. There answer was whatever is needed to hold your guts in.
Have you contacted a lawyer for this? This seems negligent at best
lawyer up and get professional consult and review of records... even though maybe some time limitations apply, hopefully you have had much if not all this documented by another valid licensed health care provider of various licensures
Interesting, to my limited knowledge that hospital is known to be one of the best on the planet, surprised as it's the first comment about it that I see and it's being negative, i guess people tend to talk more when things are negative than not hence why, but wish you the best man.
I would argue the threshold to convert to randomized trial is the %failure rate of standard chemoRT surgery. I have contacted my colleagues to try this in cervical cancer- although there is a lower MMRd rate there. But toxicity for chemoRT is extreme for those patients.
*so thats where john left his jacket.* im getting one of those. -JC
The Alzheimer example. I wonder if a multiple baseline study would show causality without the need for a randomized control trial.
Performing the MME on different probes before and after starting the medication, with delaying the introduction of the medication across the participants.
A single case research design.
In Destiny, is there any way they used a cutoff of ER
Since cancer overall is simply something going wrong in your body cell regenerations plus all the safety mechanism failing, the idea to help the system that is MADE to kill broken cells (which can become cancer if this does not happen) is a very good and promising one.
Dostarlimab - I can't imagine they would allow a therapy that cures cancer, but maybe if they can make it not work by adding something terrible it could be allowed to go to market.
Can we acknowledge we have a society where the fear of death is weaponized to make money?
I can not see getting ONE MIRACLE DRUG FOR ALL CANCERS. I had chemotherapy for WADENSTRUM NHL and for breast cancer I had lumpectomy , and radiotherapy.Both were diagnosed by MRI. at the same time but which NHL was ultimately diagnosed by bone biopsy. My mother had surgery for rectal cancer in the 1970s she ended up with a colostomy no radiotherapy no chemotherapy and never had reoccurrence died at 91 in OCT 2020 and not from COVID 19
Thank u for your comments❤
Need some more Jeb Zambrozik/Marty Mackary/Covid Policy videos! They are sooooo good
The question is are sub-clinical micrometastases also destroyed? Longer follow-up and distant relapse-free survival data will tell... but with only a few patients, we may not get an answer...
i have no clue what he’s talking about most of the time but i still listen
Nice jacket/shirt combo?
thanks?
😅
My son has colorectal cancer stage 4. Do you think Dostarlimab would be helpful in his case. How can patients get this treatment?
Signing up for a clinic trial maybe?
He needs to have a specific mutation in the tumor type that they leverage
Separate topic, but would love to hear Vinay's thoughts on cancer screening. I used to open that can of worms with patients and "have a discussion" about doing PSA testing, or what age to start mammograms, but in a post-Covid world it's become very difficult.
I don't want an annual mammogram unless I have had cancer in the past or it runs in my family.
Now that medicine has moved from in-person care to telehealth virtual appts, I am not sure how many patients will continue w regularly scheduled mammograms.
He talks about it a bit on his podcast with Zdogg. VPZDshow
No sweat Doc, we know your thing is medicine not video production. All good.
Still, though.. his videos look and sound amazing.
Medicine not video production is his thing like comedy not banjo playing is Steve Martin's thing!
@@MeanBeanComedy actually Martin’s banjo playing was pretty good, just like Victor Borge’s piano playing.
@@damiangrouse4564 That's what I was saying!
And Martin's banjo isn't just pretty good. It's really freaking good.
@@MeanBeanComedy may have been what you meant but not what you said.
@@damiangrouse4564 No, it's quite literally what I said.
At first doctors couldn’t find anything medically wrong with Cheryl other than a slightly elevated white blood cell count, Gianni said. But then MRI imaging of the brain showed evidence of prion disease, prompting doctors to immediately perform a lumbar puncture - which ruled out acute infection, tuberculosis, syphilis, multiple sclerosis and other diseases.
Translation for the common folk, please.
If this thing is even close to ChemoRT it's potentially revolutionary, It's toxicity profile is just so wildly better than the SoC
Your slides window is too small. Please make it at least 1/3 of the video.
I wish ....Chadwick Boseman have gotten this.
He'd still be alive! T_T
Vinay Prasad does a great service with these CZcams videos. But, close your eyes and listen, has Vinay stolen Quentin Tarantino's voice?
Why are you speaking in initials?
Cens0rship from utube
Ohhhhh
@@neecynew58 we live in a different world now.
Someday, somehow, we will have open discussion unfettered by sin-soring by the smaller minds. 👍
I’m still waiting to hear your thoughts on Pfizer’s covid vaccine trial documents, which is throwing lots of question about how safe and effective they are.. given the fact that Pfizer was recently made by the judge through freedom of information to release this info rather than keeping it closed from us for 75? Im just not sure why you haven’t commented on such an important issue as we just gone through.
It's something few people want to touch.
No sound again. Not sure why?
Sound works fine.
It's come back on now. This happened on last video OK NOW cheers
@@jamesparry1547 likely another YT issue
♿️♿️♿️
Don't let Pfizer near it, pleeeeaaaassse🥴
Dostarlimab - isn't this a cocktail of carrot juice and IVM? The cost of carrots is going to go up!
[ Note: IVM has nothing to do when DOS starlings, etc. I like carrots better than I like sticks. ]
Ramix, you're so funny I had a laugh😊
Anyway "LET food be thy medicine"😉
@@dedetudor. "If a man would live forever, he would have sage in his garden."
@@ramixnudles7958 love that sage. 👍
@@dedetudor. I paraphrased it. I've been looking for the actual quote, but sometimes TOO much information is worse than too little.
😂
🤣 Big business striving to 'cure' people, ie lose billions of customers and dollars.
We've been hearing this for decades yet it all gets forgotten and we stick with treatments ie $$$
Stage 3, no MSI, and pMMR here. BUT but but. I looked at other studies where this drug was used, and even some ppl who were pMMR like me did well. So why can't I try this drug? Why am I stuck with standard of care burn poison and slash? Why TF didn't anyone tell me about the in vitro and in vivo papers on everything from allicin to curcumin? Why didn't anyone tell me about the microbes associated with RC? WHY TF didn't anyone tell me SCFAs might encourage apoptosis? Why didn't anyone tell me exercise suppresses HDAC and endogenous glutamine production? Why TF didn't anyone tell me to go vegan, which I did the day of my dx, and how now except for this stupid tumor my bloodwork is perfect, just perfect? My CEA did climb slightly, but I was dehydrated the day of the second test, and besides which, both numbers are low low low in the non-smoker category. It's been 1.5 months since dx, and after the vegan, the tinctures and herbs blah blah I have 2x the energy I had before not to mention less bleeding and bc high fiber no garbage vegan absolutely no constipation. Plus, I lost 30 lbs, not bc of the cancer but bc of vegan plus several 24-hr fasts. Hemoglobin perfectly normal, btw, as is everything else other than high percentage of monocytes (absolute # is normal) which may be due to vegan. Why can't I get a FMT? Why can't I find out more about that new cell that's activated by interleukin 15? I'm almost 70, and I'd rather be in a trial than this bs standard of care, bc I guarantee you that I won't be part of the 70+% if I have to get a permanent bag.
Have you taken a look at Thomas Seyfried’s research using a metabolic model to cancer? It might be worth your time, or perhaps might give you another tool for your tool kit.
@@miklimecat9636 ty, yes I'm familiar with his work, but other than being familiar with it IDK what to do about it. Pulses agree with me, and apart from ditching the pulses and the 6 ozs. of berries in my daily kale smoothie IDK what to do. Do you think I should add MCT? Please LMK if you have any suggestions.
Let’s see, regarding Seyfried’s model, the broad strokes are that all cancers require glucose and glutamate to grow. Therefore, all cancer patients might very well improve if the cancer is prevented from getting what it needs to proliferate. The glucose can be controlled via a Ketogenic diet, or even a low carb diet. But the glutamate needs a drug (I don’t know what, you’ll have to research to see if he’s named it somewhere). Glutamate can’t be controlled by the diet. But at least you can control half of the equation. Are you familiar with the Ketogenic diet? Basically you keep your total carbs per day at 20g or less. Once you’ve adapted to it, your body burns primarily fat for fuel (in the form of ketones) instead of glucose. He also very specifically said that one would need to keep a ratio of glucose to ketones very low. Meaning, keep your blood glucose low while keeping your ketone level high. You measure your blood glucose and divide it by your measured ketones, and the ratio has to below 2(?) I believe. There are blood glucose meters out there that can also measure ketones so you can easily find your ratio, your Glucose-Ketone Index, or GKI. He’s also said he actually doesn’t specify any diet as long as you succeed in getting a low GKI consistently. Keto and low carb (and perhaps the Carnivore diet?) are just the most obvious diets that get rid of the carbs. All carbs turn into glucose in the body, that’s why ditching the carbs is helpful.
That’s all I know so far. Hopefully you can learn more yourself and see if something here might be helpful for you.
Your comment is interesting indeed, but you used so many abbreviations, is hard to understand. What microbes associated with RC?
Correction to my previous comment: all cancers need glucose and *glutamine* to proliferate.
Also, the drug Seyfried used in his research to block glutamine was something called DON, which is I think the abbreviation. He said there are analogs of it around.