Postby boxhill » Fri Aug 03, 2018 11:58 pm
I find it interesting that the article on "sidedness" never mentions MSI vs MSS, or Keytruda.
Right-side tumors are more likely to be MSI-H and thus more likely to have a good response to Keytruda, while left-side MSS tumors do not. The article emphasizes drugs that affect the EGFR pathway only. That's fine for KRAS wild-type folks. It is increasingly irrelevant to the rest of us as new drugs emerge.
I think that it is likely that the information in the 2017 article is based on outdated science, just as the "survival rates" cited in various places such as Wikipedia are out of date, because they were compiled from cases that were treated before a significant number of current drugs were even available.
I'm not going to sink into gloom on the basis of that article.
F, 64 at DX CRC Stage IV
3/17/18 blockage, r hemi
11 of 25 LN,5 mesentery nodes
5mm liver met
pT3 pN2b pM1
BRAF wild, KRAS G12D
dMMR, MSI-H
5/18 FOLFOX
7/18 and 11/18 CT NED
12/18 MRI 5mm liver mass, 2 LNs in porta hepatis
12/31/18 Keytruda
6/19 Multiphasic CT LNs normal, Liver stable
6/28/19 Pause Key, predisone for joint pain
7/31/19 Restart Key
9/19 CT stable
Pain: all fails but Celebrex
12/23/19 CT stable
5/20 MRI stable/NED
6/20 Stop Key
All MRIs NED