Pyro70 wrote:[rp1954] in numerous cases extolled the benefits of CIM here and in other threads said it “knocks the socks of FOLFOX”.
… Some people are very responsive to chemotherapy .
Pyro70 wrote:… Everyone knows that in the adjuvant setting surgery is far more important than medical treatment. Most likely these patients were “cured” by surgery not CIM.
You could see the same thing happen in a small FOLFOX trial, but you won’t because no one looks at small data sets that are potentially misleading for FOLOX anymore.
…. but ignore another trial (or weren’t aware of) that can be found with a 2 minute google search.
Then you say you need to “educate” oncologist on things like CIM therapy and are shocked that they aren’t aware of it. Yes, they likely aren’t aware of it because ...
It’s not as simple as using a single small trial to guide decisions. That’s why there are guidelines to help make sense of various trial outcomes and identify the strongest / sufficient data.
But whatever, it really isn’t worth my time discussing with you because you seem hell bent on promoting weak/junk science.
… Your support for the Swiss immune treatment that started this thread is another example of offering your support for a treatment without any evidence of efficacy.
For all I knew, your wife had stage iv with liver met(s?).
Pyro wrote:If you’re smarter than oncologists, and near the level of Einstein,
… why not become an Oncologist? It’s a serious question, using your own words, not a defamation.
rp1954 wrote:properly tissue targeted mode, metronomic 5FU-cimetidine has a reasonable claim of far better adjuvant OS performance than Folfox even today
rp1954 wrote:If repeatable, this would be faaaaar better than Folfox or Xeloda alone for the same type of CA199+CSLEX1 marked patients.
rp1954 wrote:...added cimetidine would have a good chance of having better stats than Folfox killing off escapees.
rp1954 wrote:There were plenty of placebo deaths in Figure 3D, Matsumoto (2002), 80% mortality for the CA199 tissue marker alone, faaaaar more than the other non-CSLEX1/CA199 CRC types. The Matsumoto paper is abundantly dotted with statistically significant results like p=0.0001, p=0.001, p=0.0015, p=0.006, p=0.0026, p=0.0002
Our study was so small a number scale that further large-scale study should be investigated to assess the effect of cimetidine to colon cancer with high expression of sialyl Lewis antigens.
rp1954 wrote:You promote that fresh little turd of a trial with systematic errors (clear ones and likely ones) with no statistically significant results on random errors (e.g. p = 0.92, p = 0.69, p = 0.59, p = 0.28) as if it were a deal breaker over multiple papers with 421 patients, with the characteristic "Y" and statistical significance. Your negative howl still misses the (non-significant) net positive benefit values for CIM, where you state this as if they were actually negative, with higher tx'd mortality !
Jeez, junk science indeed.
rp1954 wrote:Your negative howl still misses the (non-significant) net positive benefit values for CIM, where you state this as if they were actually negative, with higher tx'd mortality !
rp1954 wrote:The paper has the normal medical (mis)use conventions by not explicitly stating "significance" or "significiantly", so that a non-significant positive result is verbally reversed into a big negative.
Pyro70 wrote:rp1954 wrote:...added cimetidine would have a good chance of having better stats than Folfox killing off escapees.
natelaugh:...My dad is 79 with colon cancer stage 3b with T3N2AM0. … Should my dad do the chemotherapy?
natelaugh: My dad oncologist think 2 drugs FolFox for 6 months might be too much for my dad. He said that Oxaliplatin is very toxic and only add a few 2-3% to overall "Disease-Free Probability Following Surgery". He used this tool to get probability https://www.mskcc.org/nomograms
Do you think or anyone know that using only 5FU for mop up work/effective??
jpb571111: am T3N1. Started folfox in Feb 2019 4/12 cycles complete. My CEA level is .07( very low).
The f5u is very strong and alotta side effects. My onc recommended Folfox ( which sounds like the norm)
The side effects are horrible..nausea, fatigue, cold sensitivity, throat issues, constipation. This list goes on..
The f5u is a small portion that I get at the end and take home. Folfox is 3 parts.. not sure you can do just one..
My mouth issues are from the folfox..
Pyro: If his health is poorish anyway, no. I’ll say it, chemo is hell.
rp1954: 5FU works best when it is sensitized or aided by something else. In the literature, in other places, depending on the markers, these could be as mild as PSK correlated with the CEA marker, maybe IV vitamin C for both cancer inhibition and reduced side effects if his cancer is KRAS/BRAF mutant, and if his CA199 (cancer tissue, or pre-op blood samples) was not too low, added cimetidine would have a good chance of having better stats than Folfox killing off escapees.
Pyro70 wrote:I believe you're trying to make the claim that the since the Matsumoto saw 100% 5-year survival for the CSLEX1 CIM treated subgroup and the trial was statistically significant that:
1. CIM is better than FOLOX (for this genetic subgroup) since FOLOX adjuvant treatment doesn't have nearly a 100% survival
Pyro70 wrote: 2. Because the p value < .05 the the 100% survival must be due to CIM and not chance or another factor
Pyro70 wrote: Again you cannot compare relative effectiveness of agents without a direct comparison in the same trial. Keytruda vs. Opdivo/Yervoy for MSI-H cancer is a good example. Currently it is assumed that Opdivo/Yerov has a higher response rate by looking at their respective trials. But experts in the field will say we don't know this for certain yet since there hasn't been a direct comparison of these immunotherapy protocols.
Pyro70 wrote: Another important point regarding Matsumoto. Yes, the results were statistically significant but it was still a very small trial (only 22 treated patients in your subgroup of interest with 13 excess survivors). p<0.05 only tells us that the difference between control and experimental arm is likely not due to a RANDOM sampling error ("reject the NULL hypothesis"). It does NOT mean there weren't systematic issues, such as a difference in patient population between the control and experimental arm. With a trial this small, it is all too easy to introduce systemic errors because the patients were just different (different tumor type/biology (e.g. right vs left, differentiation, MSI, etc.) , extent of disease involvement, surgical skill/luck). Remember the results depend entirely on those 13 extra survivors, there could easily have been a number of the 13 out the 22 CIM treated patients that had an inherently better prognosis than the control group average.
In summary this Matsumoto trial by itself is too small to definitively say CIM is an effective treatment and it doesn't tell us anything regarding the effectiveness of CIM vs. FOLFOX - a claim you've made many times. The trial would need be larger (and frankly the benefit would have to be shown in a second trial) before CIM therapy would be accepted as effective treatment and be included in evidence based guidelines. This is something Matsumoto acknowledged in his article, but you chose to ignore as you're advocating patients to use CIM:Our study was so small a number scale that further large-scale study should be investigated to assess the effect of cimetidine to colon cancer with high expression of sialyl Lewis antigens.rp1954 wrote:You promote that fresh little turd of a trial with systematic errors (clear ones and likely ones) with no statistically significant results on random errors (e.g. p = 0.92, p = 0.69, p = 0.59, p = 0.28) as if it were a deal breaker over multiple papers with 421 patients, with the characteristic "Y" and statistical significance. Your negative howl still misses the (non-significant) net positive benefit values for CIM, where you state this as if they were actually negative, with higher tx'd mortality !
Jeez, junk science indeed.Pyro70 wrote:First, I don't promote this trial. I provided it as counter-evidence to the Matsumoto trial. I'm not claiming either trial is better or worse. I'm saying we don't know which trial to believe.
Pyro70 wrote:Second, this "little turd" of a trial was twice the size of the Matsumoto trial with 2x the number of CIM treated patients in the experimental arm (34 vs. 65 CIM treated patients in Matsumoto and Jameson respectively).
Pyro70 wrote:Third, you discount the trial because you don't like the results even though you haven't seen the full paper for the trial
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