Thanks for the update. This is getting more and more complicated and more and more confusing (to me) with each iteration. So, your wife had at least 4 surgical procedures done, maybe some of them done on the same day. Can you give the dates (month, year) of: 1. the emergency surgery 2. the colostomy reversal procedure, 3. the ovaries/fallopian tubes surgery, 4. the ureter tumor surgery?
Also, in the same sequence, can you give the start/stop dates (month, year) of the chemo regimens?
And what were the results of the most recent CT scan, and was it a full thorax/abdomen/pelvis scan done "with contrast"?
And where did your wife get the second opinions done? At the cancer center, or at a different place?
Has your wife asked whether the ureter tumor was a "local recurrence" vs a "remote recurrence"? Has she asked whether or not the ureter tumor was actually a malignant lymph node?
Sorry for all the questions, but there are still a lot of issues that need to be clarified. Thank you.
boxhill wrote:Equivocal MSS/MSI? That's a new one on me. Seems to generally be a result of testing failure because of poor sample or something like that. Can you delve into that more? What was equivocal about it? Not sure about dMMR/pMMR? Something else? MSS with high TMB maybe?
Being responsive to immunotherapy would definitely be huge. If it were me I would insist on retesting with a fresh sample, and I would pay for it myself if necessary. It doesn't have to be Foundation One.
There are two approaches to assessing MSI status: IHC testing, and PCR testing. They give equivalent results, but in different formats.
If the MSI test that they did was "equivocal" they could do another test with a different tissue sample, and they could use the same approach or the alternate approach to testing. In my opinion, there is no excuse to accept an "equivocal" finding. They should persevere until they get a good result that is unequivocal.
MSI status is required for all CRC diagnoses and is an important part of the overall diagnosis and treatment scenario.