Can some women with early breast cancer avoid chemotherapy?

Yes, according to a study presented and discussed at the ASCO 2026 Annual Meeting in Chicago ( ASCO- American Society of Clinical Oncology).

Breast cancer can be hormonally driven and hence hormone therapy is widely used for a sub-group of breast cancer patients. (ER positive cancers). Some of these women have also high risk features on conventional assessment and hence are currently offered chemotherapy as an additional option.

But chemo really helps only a smaller proportion of the patients. It had been difficult so far to identify this smaller proportion of patients so far.

Now a test promises to help a lot of breast cancer patients to avoid chemotherapy.

A study involving more than 4000 women evaluated this test called Prosigna. The study results were presented and discussed at the ASCO 2026 Annual Meeting in Chicago.

The study found that more than two thirds of women could be spared the side of effects of chemotherapy.

Only patients who had a Prosigna test score of more than 60 were given chemotherapy plus hormone therapy combination in this study.

The study showed that patients with a Prosigna test score of less 60 can be safely treated with hormone therapy alone without chemotherapy.

References.

1. BBC website. Millions of breast cancer patients could safely avoid chemotherapy, study suggests. Alicia Curry. 31/5/26.

2. Breast Cancer Now . Prosigna.

3. ASCO. First results from the OPTIMA phase III randomized non-inferiority trial of test-directed chemotherapy in patients with high clinical risk ER-positive HER2-negative early breast cancer.

4. Prosigna assay. More information:on the test.

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information research only and do check the sources where cited. But the author cannot vouch for scientific integrity of the sources cited and author is not responsible for any information in any advert on those cited pages. Please DO consult your own doctor to discuss concerns and options, which are directly relevant and specific to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting this blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Should high risk prostate cancer patients have “doublet hormone therapy” before prostate surgery ?

Yes, according to recent study presented and discussed at the ASCO 2026 Annual Meeting in Chicago ( ASCO- American Society of Clinical Oncology).

In a study involving more the 2000 patients, the investigators found that having two types of hormone therapy “significantly increased the curative success” of radical prostate surgery compared to having one type of hormone injection only.

Vast majority of patients in this study had high risk prostate cancer which is potentially amenable for surgery.

Average PSA level was 14.8 ng/mL; the Gleason score was 8 or above in more than 95% of patients (GS ≥8, 95.8%.). The study has a fairly long follow up duration (Median follow-up was 61.7 mo).

The results are likely to be practice changing but implementation might differ between UK and USA. This is partly due to funding restrictions and also partly because the control of this trial involved radical prostate surgery with one type of hormone injection only which is not standard of care at present in UK.

Clinical practice do evolve over time.

Hormone therapy, in both arms of this trial, was given 6 months before and 6 months after surgery. Hormone therapy can cause various side effects including loss of libido, which does need to be discussed during the consultation.

References

ASCO 2026. Perioperative (neoadjuvant and adjuvant) apalutamide (APA) + androgen deprivation therapy (ADT) vs placebo (PBO) + ADT with radical prostatectomy (RP) in high-risk localized or locally advanced prostate cancer (HR LPC/LAPC): Final analysis of the PROTEUS phase 3 study.Mary-Ellen Taplin, MD, FASCOLank Center for Genitourinary Oncology, Dana-Farber Cancer Institute. ASCO Abstract LBA1

NEJM Perioperative Apalutamide in High-Risk Localized Prostate Cancer. Authors: Mary-Ellen Taplin, M.D. Martin Gleave, M.D., Neal D. Shore, M.D., Angela Lopez-Gitlitz, M.D., Alexander Kretschmer, M.D., Eleni Efstathiou, M.D., Paul L. Nguyen, M.D., +16 , for the PROTEUS Investigators*

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information research only and do check the sources where cited. But the author cannot vouch for scientific integrity of the sources cited and author is not responsible for any information in any advert on those cited pages. Please DO consult your own doctor to discuss concerns and options, which are directly relevant and specific to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting this blog and MAY CHANGE overtime, particularly when new evidence comes to light.

New treatment for 2nd line treatment of pancreatic cancer

Pancreatic cancer: image from Wikipedia

Pancreatic cancers patients have worse prognosis than most other common cancers. The cancer research UK states only “25 out of every 100 (25%) survive their cancer for 1 year or more”.

Chemotherapy is the main treatment for advanced pancreatic cancer.

While immunotherapy and targeted therapy options have made great inroads into successfully prolong lives of patients with various other cancers, pancreatic cancer patients were left behind.

Only a small minority of pancreatic cancer patients benefited from targeted therapy so far.

Now there is a breakthrough !

Daraxonrasib is the name of the promising new drug.

Trial results were presented and discussed at the ASCO 2026 Annual Meeting in Chicago ( ASCO- American Society of Clinical Oncology).

The study author’s presentation of trial results of Daraxonrasib in pancreatic cancer received a standing ovation!

Daraxonrasib (“darax”) doubled the survival pancreatic cancer patients in the second line setting .

Results are extraordinary and are now published in the prestigious New England Journal of Medicine.

The drug will be the standard of care now in 2nd line setting.

A word of caution about availability!

American FDA has given the green light but it might take many months before it becomes available in European Hospitals for pancreatic cancer patients.

References

Lay public summary. ASCO. Oral targeted therapy slows pancreatic cancer growth, improves overall survival. Published 31 May 2026.

ASCO 2026: Daraxonrasib, a RAS(ON) multi-selective inhibitor vs chemotherapy in previously treated metastatic pancreatic adenocarcinoma (mPDAC): Primary and final analysis from the phase 3 RASolute 302 study. Abstract LBA5

Guardian newspaper. Daily pill can double survival time for world’s deadliest cancer, trial shows: Experts hail daraxonrasib as ‘gamechanger’ for patients with advanced pancreatic cancer

BBC News. Daily pill doubles survival time for pancreatic cancer patients

MHRA UK

Image credit: https://media.pn.am/media/issue/271/776/photo/339x226_thumb_photo_271776_a4f3e2a65.jpg

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information research only and do check the sources where cited. But the author cannot vouch for scientific integrity of the sources cited and author is not responsible for any information in any advert on those cited pages. Please DO consult your own doctor to discuss concerns and options, which are directly relevant and specific to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting this blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Advanced Lung cancer : more treatment choices.

More than 20 years back, lung cancer patients did not have many treatment options and most patients died very quickly.

Now there is an explosion of choices for patients with a type called “non-small cell lung cancer”.

Lot of new drugs were presented and discussed at the ASCO 2026 Annual Meeting in Chicago ( ASCO- American Society of Clinical Oncology).

Sunvozertinib: Abstract LBA8500

Amivantamab plus lazertinib in atypical EGFR-mutated NSCLC: Abstract 8501

Neladalkib in patients with advanced ALK+ NSCLC: Abstract 8503

Pralsetinib as first-line treatment of RET fusion–positive: Abstract 8504

Sacituzumab tirumotecan (sac-TMT) plus pembrolizumab: Abstract 8506

Benmelstobart plus chemotherapy and Anlotinib: Abstract LBA8507

The subset of patients cancers, who can be targeted by therapy would have prognosis improved by these drugs.

I am not publishing this blog as a lung cancer expert recommending treatments. Please DO consult your own doctor to discuss concerns and treatment options, which are directly relevant and specific to you.

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information research only and do check the sources where cited. But the author cannot vouch for scientific integrity of the sources cited and author is not responsible for any information in any advert on those cited pages. Please DO consult your own doctor to discuss concerns and options, which are directly relevant and specific to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting this blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Does Radioactive “Radium” injections help advanced Kidney cancer patients ?

Radioactive substances have been used for cancer treatment ever since they were discovered.

Radium 223 is one such substance. Unlike many other radioactive isotopes, it is a very short acting radioactive substance. Within a matter of few weeks, it loses its radioactivity rapidly.

Radium 223 is an injectable form of radium. When injected into the veins, it preferentially goes to the bones.

It has been shown to help PROSTATE cancer patients whose cancer has spread to the bones. It is often used in PROSTATE cancer patients, after chemotherapy and hormone therapy treatments have failed.

In a recent study, Radium 223 was evaluated in KIDNEY cancer patients who have bone secondary cancer. The study is being presented at the Annual meeting of American Association of Clinical oncology in Chicago ( June 2026).

In this study, KIDNEY cancer patients with bone secondaries ( bone metastasis) were either given cabozantib tablets on its own or cabozantib tablets + Radium 223 injections.

The primary end point of the study was unfortunately negative. Bone related problems not difficult between the two groups .

But the survival rates are intriguing. Overall survival numbers are better for Radium group with 32 months of survival versus 21 months for cabozantib only group.

It is a small study and survival results were not statistically significant. So it could be only regarded as hypothesis generating rather than practice changing.

Hopefully future trials will look at role of Radium 223 in advanced Kidney cancer patients who have bone metastasis.

Take away points from presentation.

Fair use- Image Copyright is with ASCO

References

ASCO 2026 Annual meeting. 2:45 – 2:57 PM CDTA phase 2 randomized trial of radium-223 dichloride and cabozantinib in patients (pts) with renal cell carcinoma (RCC) with bone metastases (BM): RADICAL (Alliance A031801).Rana R. McKay, MD, FASCOUC San Diego Moores Cancer Center. Abstract 4500

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information research only and do check the sources where cited. But the author cannot vouch for scientific integrity of the sources cited and author is not responsible for any information in any advert on those cited pages. Please DO consult your own doctor to discuss concerns and options, which are directly relevant and specific to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting this blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Tumour genetic material in blood circulation : effect on cancer relapse after a complete surgical resection of kidney tumour

Cancer can come back in many high-risk kidney cancer patients even after a successful operation.

This is because tiny tumour cells can remain in body undetectable by scans.

This is why immunotherapy is given to patients after successful surgery in high risk kidney cancer patients. ( Pembrolizumab).

New technology enables detection of tumour DNA ( genetic material) in blood circulation.

In the study, which evaluated a immunotherapy drug called Pembrolizumab, the investigators assessed the stored blood samples of kidney cancer patients.

They found tumour DNA circulating in the blood stream in up to 20% of patients with high risk cancer. These patients did not do well over long term.

Patients who were able clear the tumour DNA from circulation at the 15 week period ( either spontaneously or with help of immunotherapy) did better .

This is an evolving area . The routine use of tests for detection of tumour DNA is likely to be one more common in future.

The results of this study are being presented at the Annual meeting of American Association of Clinical oncology in Chicago ( June 2026).

References

ASCO 2026 Annual meeting. ctDNA analysis in participants with renal cell carcinoma treated with adjuvant pembrolizumab or placebo in the KEYNOTE-564 trial.Toni K. Choueiri, MD, FASCODana-Farber Cancer Institute, Harvard Medical School. Abstract 4502

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information research only and do check the sources where cited. But the author cannot vouch for scientific integrity of the sources cited and author is not responsible for any information in any advert on those cited pages. Please DO consult your own doctor to discuss concerns and options, which are directly relevant and specific to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting this blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Blocked nose: be careful with the nasal decongestant drops and sprays

The arrival of spring and summer causes Hay fever to cause discomfort among the sufferers.

Traditionally, anti-histamines and steroid nasal sprays are used for symptom relief.

Some people use nasal decongestants to help with symptom relief.

The UK authorities has released an alert advising people to limit use of nasal decongestants.

The agency advises to limit use of nasal decongestant sprays containing xylometazoline and oxymetazoline to a maximum of five days due to side effects of prolonged use.

References

  1. BMJ. Limit use of nasal decongestant sprays to five days, UK regulator says
    BMJ 2026; 393 doi: https://doi.org/10.1136/bmj.s849(Published 01 May 2026)Cite this as: BMJ 2026;393:s849
  2. MHRA. Recommended use of some nasal decongestant sprays limited to five days by UK regulator (The MHRA has limited the use of nasal decongestant sprays containing xylometazoline and oxymetazoline to a maximum of five days due to side effects of prolonged use). From: Medicines and Healthcare products Regulatory Agency. Published 30 April 2026

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information research only and do check the sources where cited. But the author cannot vouch for scientific integrity of the sources cited and author is not responsible for any information in any advert on those cited pages. Please DO consult your own doctor to discuss concerns and options, which are directly relevant and specific to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting this blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Hantavirus – ground zero ?

Hantavirus is in the news worldwide after it caused fatal infections in at least a couple of Cruise ship passengers.

The ground zero – that is where the infection of cruise passengers first occurred – is still yet to be determined.

The Dutch vessel MV Hondius deparated from the Argentina’s southernmost city, Ushuaia. A landfill site on the outskirts of Ushuaia has been potentially marked as a source of infection.

The Argentine health officials there in Ushuaia deny that their city is the source of infection.

It’s going to take a longtime to establish a source and even then, it may never be conclusively established just like coronavirus.

“Lab leak theory” ( from Wuhan lab) was prominent for COVID virus along with “animal origin theory ( Wuhan market).

But with the recent Hantavirus break, an “animal origin (rodents)” is being looked at and there is no suggestion of a lab origin so far.

References

BBC News. 10 May 2026. Tourist hotspot at ‘end of the world’ denies causing hantavirus outbreak.

BBC News.1 March 2023. Covid origin: Why the Wuhan lab-leak theory is so disputed.

BMJ 9 Sept 2024. Will we ever know where covid-19 came from? BMJ 2024; 386 doi: https://doi.org/10.1136/bmj.q1578(Published 09 September 2024)Cite this as: BMJ 2024;386:q1578

BBC News. 19 Sept 2024. Genetic ghosts suggest Covid’s market origins.

BBC News. 26 Jan 2025. CIA says lab leak most likely source of Covid outbreak.

WHO News. 27 June 2025. WHO Scientific advisory group issues report on origins of COVID-19..

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information research only and do check the sources where cited. But the author cannot vouch for scientific integrity of the sources cited and author is not responsible for any information in any advert on those cited pages. Please DO consult your own doctor to discuss concerns and options, which are directly relevant and specific to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting this blog and MAY CHANGE overtime, particularly when new evidence comes to light.

About Hantavirus and how to get reliable trustworthy information

The Hantavirus infection of passengers in a Cruise ship has got many people worried worldwide.

The Dutch ship- MV Hondius – departed from Argentina on 1 April, with about 150 passengers and crew from 28 countries.

Some passengers seem to have picked up the infection in Argentina. At least two people are reported to have died of the Hantavirus infection.

It is important to remember that Hantavirus infection is not always deadly. Lot of people do seem to recover from it. But some people can develop serious lung problems or Kidney and bleeding problems.

The ship has now arrived at Canary Islands and passengers will be expected to go their own countries. Could this spread the virus widely ?

The experts are reassuring the public by pointing out the Hantavirus infection is very different from COVID-19 . The WHO experts does not seem to be worried about another pandemic.

The virus can take more time to cause symptoms and that’s why returning British cruise passengers face a 45 day isolation (quarantine ). As the experts learn more about this subtype of virus, precautions may change in future.

It is important that everyone looks at source of information on social media and resist the urge to forward sensationalist messages from untrustworthy sources.

How to get reliable trustworthy information?

If possible, do not pay attention to information from social media sources, which are not a well sourced.

Try the mainstream newspapers and TV news. (eg BBC, ITV, Channel 4 and Sky News) for latest information.

Try official sources in UK and USA. ( eg . UK Health security agency, CENTERS FOR DISEASE CONTROL AND PREVENTION CDC.gov)

References

BBC News 10th May 2026. Plane carrying passengers from cruise ship hit by virus lands in UK.

BBC News. Hantavirus outbreak not the start of a pandemic, WHO says, as five cases confirmed on cruise ship. 6 May 2026

BBC News. Britons on hantavirus cruise ship face 45 days of self-isolation.

Wiki. List of newspapers in the United Kingdom

UK Health Security Agency (UKHSA). What is hantavirus? How is it transmitted and what are the symptoms? Blog Editor, 5 May 2026

CDC: U.S. CENTERS FOR DISEASE CONTROL AND PREVENTION: Hantavirus

( cruise ship picture for illustration only; this is not the actual ship involved in recent outbreak of Hantavirus)

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information research only and do check the sources where cited. But the author cannot vouch for scientific integrity of the sources cited and author is not responsible for any information in any advert on those cited pages. Please DO consult your own doctor to discuss concerns and options, which are directly relevant and specific to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting this blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Does this study sound the death knell for intermittent fasting?

Dieting is very hard.

If you not obese, thank your parents for the good genes and for inculcating good dietary habits in you at a young age.

If you are not overweight, you don’t understand how utterly painful it is to diet.

People try various diets and often fail. Even people, who use Mounjaro to lose weight , can put it all back again if they stop the injections.

Any dieting is frustrating and calorie counting is hard. So “intermittent fasting” gained popularity quickly because it is relatively easy. Intermittent fasting was also very heavily promoted in social media.

Now a study reports that “intermittent fasting” is not the magic bullet.

The study author Luis Garegnani says:

“Intermittent fasting just doesn’t seem to work for overweight or obese adults trying to lose weight. It may be a reasonable option for some people, but the current evidence doesn’t justify the enthusiasm we see on social media”.

Is this the end for “intermittent fasting”?

Probably not.

Studies involving food, particularly dieting, are notoriously difficult to conduct.

So it would be hard to completely rule out “intermittent fasting” for all people. There may be some people for whom “intermittent fasting” works well. We don’t know.

References

  1. BHF. British Heart Foundation. Will coming off Mounjaro reverse weight loss and other health benefits?.
  2. Pubmed. Horn DB, Linetzky B, Davies MJ, Laffin LJ, Wang H, Murphy MA, Zimner-Rapuch S, Lau E, Arad AD, Lee CJ. Cardiometabolic Parameter Change by Weight Regain on Tirzepatide Withdrawal in Adults With Obesity: A Post Hoc Analysis of the SURMOUNT-4 Trial. JAMA Intern Med. 2026 Feb 1;186(2):157-167. doi: 10.1001/jamainternmed.2025.6112. PMID: 41284285; PMCID: PMC12645400.
  3. BBC News. Intermittent fasting may make little difference to weight loss, review finds. 16/2/26: Philippa Roxby. Health reporter
  4. Pubmed. ORIGINAL SOURCE paper. Garegnani LI, Oltra G, Ivaldi D, Burgos MA, Andrenacci PJ, Rico S, Boyd M, Radler D, Escobar Liquitay CM, Madrid E. Intermittent fasting for adults with overweight or obesity. Cochrane Database Syst Rev. 2026 Feb 16;2(2):CD015610. doi: 10.1002/14651858.CD015610.pub2. PMID: 41692034; PMCID: PMC12906965.
  5. Cochrane website. Evidence behind intermittent fasting for weight loss fails to match hype. Monday, February 16, 2026 By Mia Parkinson.

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information research only and do check the sources where cited. But the author cannot vouch for scientific integrity of the sources cited and author is not responsible for any information in any advert on those cited pages. Please DO consult your own doctor to discuss concerns and options, which are directly relevant and specific to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting this blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Fenbendazole and Ivermectin for prostate cancer : what is the evidence ?

There is a significant social media promotion of these two drug combination- fenbendazole and ivermectin – for treatment of prostate cancer.

They are relatively cheap and so cost is not a major hindrance.

Are they both any good for routine clinical use ?

The short answer is NO.

Both Ivermectin and Fenbendazole are drugs currently licensed for treatment of human and / or animal infections.

There is lot of pre-clinical laboratory evidence to indicate anti-cancer activity regarding these two drugs. But that does not mean they can be safely used clinically. Good clinical trials are needed before they can be used clinically .

Remember both drugs can have significant side effects. ( Ivermectin . Fenbendazole ).

For instance, these drugs can cause liver damage. They can cause nausea, stomach pain, muscle pain, joint pain and in worse cases cause mental changes.

Advanced cancer patients are desperate to try anything. It’s human nature to fight . But that doesn’t mean trying “unproven treatments” are a good idea. This is because the side effects of the drugs can make cancer patients life even more miserable.

Both the drugs – Ivermectin and Fenbendazole- can also interfere with other cancer treatments.

Scientifically, we cannot 100% rule out that a derivative of Ivermectin or Fenbendazole might be repurposed for cancer treatment in future.

But it is NOT a good idea to use Ivermectin or Fenbendazole as an anti-cancer treatment in routine clinical practice NOW.

Be careful. Discuss your concerns with your doctor.

Be aware of scams.

Also be very careful about friends, family members and well wishers – with good intentions – but unknowingly passing misleading information to you !

References

Macmillan. Cancer and ivermectin: What people with cancer need to know. Richard Simcock Chief Medical Officer and Macmillan. Published: 01 October 2025

Ivermectin European Data sheet. Accessed 1st Feb 2026. Patient information leaflet.

Ivermectin pil.15513.pdfDownload

Fenbendazole. DEFRA. VETERINARY MEDICINAL PRODUCT. Accessed 1st Feb 2026.

Fenbendazole SPC_138324.PDFDownload

Ivermectin Review: Ivermectin, a potential anticancer drug derived from an antiparasitic drug

Fenbendazole: Oral Fenbendazole for Cancer Therapy in Humans and Animals. Jolie Nguyen et al. Anticancer Res. 2024 Sep

Ivermectin: Integrated analysis reveals FOXA1 and Ku70/Ku80 as targets of ivermectin in prostate cancer.

Ivermectin: Ivermectin in Cancer Treatment: Should Healthcare Providers Caution or Explore Its Therapeutic Potential? Yash Patel et al. Curr Oncol Rep. 2025 Sep

False information on ivermectin continues to circulate worldwide. Published on May 14, 2025 at 22:01. Updated on May 16, 2025 at 06:59. By Ede ZABORSZKY.

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information research only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options, which are relevant and specific to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

New drug combination for advanced prostate cancer patients

NICE (National institute for health and care excellence) has approved a new drug combination for 1st line treatment of hormone refractory cancer.

The combination is made up of two drugs.

(A) talazoparib, (B) enzalutamide.

Enzalutamide is already being used for treatment of prostate cancer. Using Enzalutamide along with new drug talazoparib was found to significantly improves survival outcomes in a large clinic trial.

In USA, combination of talazoparib plus enzalutamide  has been approved only for patients with certain genetic mutations. The FDA has not approved the combination for patients without specific mutations .

In contrast, NICE in UK has approved combination of “talazoparib plus enzalutamide” for all patients irrespective of mutations. People with HRR gene mutations seem to derive the most benefit from the combination of talazoparib plus enzalutamide.

References

  1. NICE. Thousands could benefit from new take-at-home treatment for advanced prostate cancer . 23 January 2026
  2. NICE Guidance. Talazoparib with enzalutamide for untreated hormone-relapsed metastatic prostate cancer [ID4004].
  3. Urology times. News|Articles|June 17, 2025. FDA does not approve talazoparib plus enzalutamide for non-HRR gene mutated mCRPC
    Author(s)Hannah Clarke
  4. Lancet: Volume 406, Issue 10502P447-460. August 02, 2025.
    Talazoparib plus enzalutamide in men with metastatic castration-resistant prostate cancer: final overall survival results from the randomised, placebo-controlled, phase 3 TALAPRO-2 trial.

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information research only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options, which are relevant and specific to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

New drug approved for Prostate in England

Patients, who have advanced prostate, have a new option for controlling prostate cancer.

Darolutamide is a well tolerated, second generation drug for treatment of prostate cancer.

NICE ( National Institute for Health and Care Excellence) has analysed the drug efficacy and approved Darolutamide for routine clinical use.

Darolutamide need to used along the standard hormone injections which lower serum Testosterone.

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information research only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options, which are relevant and specific to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Which food preservatives increase risk of cancer and diabetes ?

An elegant study published in BMJ shows that commonly used food preservatives and additives can increase risk of Cancer and Diabetes.

Some officially approved and commonly used, food additives such as “sodium nitrite, potassium nitrate, sorbates, potassium metabisulfite, acetates, acetic acid” and Antioxidant preservatives such as Sodium erythorbate have been found to be associated with increased risk of cancer.

In addition these preservatives– potassium sorbate, potassium metabisulfite, sodium nitrite, acetic acid and sodium acetate– were also found to increase the risk of diabetes”.

Other additives such as “calcium propionate, alpha-tocopherol, sodium ascorbate, rosemary extracts, sodium erythorbate, phosphoric acid and citric acid” were also associated with diabetes risk.

What does it mean?

In practical terms- preservatives and additives are everywhere.

Study revealed that

  • about 85% sulfite intake was from alcoholic drinks;
  • about 50% of nitrites, 80% of nitrates, and 40% of erythorbates from processed meat.
  • about 50 % of ascorbates and 25% of citrates from processed fruit and vegetables;
  • about 30% of tocopherols from breakfast cereals.

With such widespread presence of these preservatives in practically all processed foods, it would be hard to avoid them.

Unless one consumes organic fresh food only, it is hard to avoid additives and preservatives. So the compromise approach would be to minimise processed food as much as possible.

A word of caution. Obviously, with any observational study, there would be unknown factors and we definitely need more confirmatory studies.

References

  1. CNN. Common food preservatives linked to cancer and type 2 diabetes
  2. BMJ. Intake of food additive preservatives and incidence of cancer: results from the NutriNet-Santé prospective cohort
    BMJ 2026; 392 doi: https://doi.org/10.1136/bmj-2025-084917 (Published 07 January 2026). Cite this as: BMJ 2026;392:e084917 

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information research only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options, which are relevant and specific to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

How to make prostate cancer patients better tolerate chemotherapy ?

In patients with incurable & widespread prostate cancer, one of the treatment option is a combination of three treatments (“TRIPLET THERAPY”)

This TRIPLET combination involves CHEMOTHERAPY given with HORMONE INJECTIONS and HORMONE TABLETS.

But many prostate cancer patients are frail and elderly with multiple other medical problems. So chemotherapy is not used in those patients and only Hormone tablets and injections are used .

The DOUBLET combination of HORMONE INJECTIONS and HORMONE TABLETS do a good very job indeed and frail patients are spared the nasty side effects from chemotherapy.

A study presented at the annual congress of European Society for Medical Oncology at BERLIN shows that if chemotherapy at a lower dose and is given every 2 weeks rather the typical every 3 weeks , then chemotherapy is better tolerated. The 2 weekly schedule resulted in statistically significant and clinically meaningful reduction in the incidence of severe side effects.

References

  1. ARASAFE : ESMO daily reporter. Is less more for patients with genitourinary cancers? 17 Oct 2025 Christoph Oing
  2. ESMO . LBA92 – 3-weekly docetaxel 75 mg/m2 vs 2-weekly docetaxel 50 mg/m2 in combination with darolutamide + ADT in patients with mHSPC: Results from the randomised phase III ARASAFE trial

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information research only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options, which are relevant and specific to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Bladder cancer: Are 3 cycles of chemotherapy as good as 6 cycles – when combined with immunotherapy maintenance?

Yes; 3 is as good as 6.

The annual congress of European Society for Medical Oncology is currently underway at Berlin. Lot of exciting studies are being presented.

One of the interesting studies relate to bladder cancer. The bladder study looked at the optimum number of chemotherapy cycles that needs to be given.

Chemotherapy do cause significantly more side effects the immunotherapy. If fewer cycles are given, treatment might be more tolerable.

This bladder trial looked at giving only 3 cycles of chemotherapy compared to the standard 6 cycles.

The study found that fewer cycles improved quality of life without compromising overall benefits from the treatment

Reference

Grande E, et al. DISCUS: A phase II study comparing 3 vs 6 cycles of platinum-based chemotherapy prior to maintenance avelumab in advanced urothelial cancer. ESMO Congress 2025 – LBA 109

ESMO daily reporter. Is less more for patients with genitourinary cancers? 17 Oct 2025 Christoph Oing

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information research only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options, which are relevant and specific to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Is it useful to monitor for cancer recurrence after treatment for bowel cancer ?

No; unfortunately routine tests not useful to prolong life.

Logic dictates that early detection of bowel cancer recurrence would lead to prompt treatment and prolong life.

But cancer doesn’t do logic !

A large trial looked at usefulness of routine blood tests and scans for early diagnosis of cancer recurrence in bowel cancer patients.

The trial found that blood tests and scans were useful to diagnose recurrence early; but this early detection of recurrence ultimately did NOT improve life expectancy.

The study used tumour markers in blood [carcinoembryonic antigen CEA ] and Scans [computed tomography CT-scans] during the 5 years after surgery for bowel cancer.

Extra scans and bloods are NOT always useful.

References

  1. ESMO CEA and/or CT-scan Surveillance After Curative Surgery for Patients with Stage II or III CRC Does Not Provide Any Benefit in 5-year OS.
  2. Lepage C, Phelip J-M, Cany L, et al. for PRODIGE 13 investigators/Collaborators. Effect of 5 years of CT-scan and CEA follow-up on survival endpoints in patients with colorectal cancer . Annals of Oncology; Published online 17 September 2025. DOI: https://doi.org/10.1016/j.annonc.2025.09.004

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information research only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options, which are relevant and specific to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Is radiotherapy to prostate useful even after the cancer has escaped from prostate?

Yes, it can be helpful but only in certain circumstances.

Former US President Biden is in the news this week and multiple media outlets reports that Biden is having  radiation therapy to prostate along with hormone therapy.

The news outlets also indicate that Biden has aggressive prostate cancer which has spread to the bones.

Any spread of prostate cancer to bones is classified as stage 4 prostate cancer.

If cancer has NOT spread outside the prostate, the combination of radiation and hormones could be curative .

But, with stage 4 prostate cancer, radiation is generally not curative. This is because once the cancer cells have spread, it is extremely difficult to eradicate those cancer cells permanently. 

A large UK trial ( STAMPEDE trials) found that “Radiotherapy to the prostate did NOT improve overall survival for unselected patients with newly diagnosed metastatic prostate cancer”

So if radiation does not improve survival, why did the oncologists offer radiation therapy to Biden?

Full medical details are not available and so it is difficult to give a definitive answer in Biden’s case.

There are few possibilities.

In the above mentioned STAMPEDE trial , in a smaller select group of patients, Radiation therapy did improve overall survival in men with a low metastatic burden. ( ie fewer cells have spread).

One can only speculate whether that’s been the case with regards to Mr Biden.

References

  1. CNN. Biden starts radiation therapy for aggressive form of prostate cancer. By Kevin Liptak, Fadel Allassa. UPDATED OCT 11, 2025, 11:28 AM PUBLISHED OCT 11, 2025, 10:01 AM
  2. BBC news. Biden receiving radiation therapy for prostate cancer. By Jaroslav Lukiv. Published 11 October 2025.
  3. Lancet. Stampede trial. Radiotherapy to the primary tumour for newly diagnosed, metastatic prostate cancer (STAMPEDE): a randomised controlled phase 3 trial.

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information research only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options, which are relevant and specific to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Can Gerson therapy or alternative treatment cure cancer ?

No !

No one has published any reliable scientific evidence to prove alternative therapies such as Gerson therapy can cure cancer.

When some one is diagnosed with cancer, particularly at a young age, the shock is unimaginable!

People are so shocked they start to question everything.

People can be understandably very worried about side effects of conventional treatments such as chemotherapy.

People with cancer can be frightened about everything.

BUT alternative therapy is not the answer to their worries and concerns.

Alternative therapy has not been shown to cure cancer.

There are lot of scams on social media promoting so called alternative or complimentary therapy. Be careful!

Even worse are the misguided people who promote well-intentioned but dangerous unscientific information.

Any one who has been newly diagnosed with cancer should be aware of the enormous amount of misinformation out there.

Some complementary therapies (eg massage, aromatherapy ) can have palliative and psychological benefits but they do not cure or control the cancer.

The recent BBC news article about a young women, who died of a potentially curable cancer, should be a warning to other people.

References

BBC News. ‘Our sister died of cancer because of our mum’s conspiracy theories’. Published 23 June 2025. Marianna Spring. Social media investigations correspondent

Telegraph. Cambridge graduate ‘killed by mother’s anti-medicine conspiracy theories’. Gwyn Wright. 24 June 2025 6:21am BST

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information research only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options, which are relevant and specific to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Can exercise make cancer patients live longer?

Yes, exercise can make cancer patients live longer.

A recent study of bowel cancer patients showed that people who had a “structured exercise program” had better fitness and a longer life.

The study data was presented at the prestigious annual meeting of the American Society of Clinical Oncology (ASCO) at Chicago.

Dr Sundar is a member of American Society of Clinical Oncology (ASCO) and has been a member for more than 25 years.

References

  1. ASCO abstract. A randomized phase III trial of the impact of a structured exercise program on disease-free survival (DFS) in stage 3 or high-risk stage 2 colon cancer: Canadian Cancer Trials Group (CCTG) CO.21 (CHALLENGE).
  2. CNN news. Exercise may help patients with colon cancer live as long as those who never had it, study suggests
    By Madeline Holcombe, CNN
     4 minute read
    Published 3:02 PM EST, Mon February 24, 2025
  3. CNN. New research presents promising findings on colorectal cancer treatment and prevention
  4. BBC news. Major study shows exercise improves cancer survival.

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information research only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options, which are relevant and specific to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

New treatment option for a subset of bowel cancer patients

Advanced bowel cancer is usually treated with chemotherapy.

A subset of bowel cancers carry a genetic change called BRAF V600E mutation.

These patients benefit from addition of a drug called Encorafenib to the chemotherapy drugs.

This treatment regimen will become the standard of care for this sub-group of patients.

The study data was presented at the prestigious annual meeting of the American Society of Clinical Oncology (ASCO) at Chicago.

The results were also published in the prestigious NEJM New England Journal of Medicine.

Dr Sundar is a member of American Society of Clinical Oncology (ASCO) and has been a member for more than 25 years.

References

  1. ASCO. First-line encorafenib + cetuximab + mFOLFOX6 in BRAF V600E-mutant metastatic colorectal cancer (BREAKWATER): Progression-free survival and updated overall survival analyses.
  2. NEJM. Encorafenib, Cetuximab, and mFOLFOX6 in BRAF-Mutated Colorectal Cancer
    Authors: Elena Elez, M.D., Ph.D., Takayuki Yoshino, M.D., Ph.D., Lin Shen, M.D., Sara Lonardi, M.D., Eric Van Cutsem, M.D., Ph.D., Cathy Eng, M.D., Tae Won Kim, M.D., Ph.D., +13 , for the BREAKWATER Trial Investigators*Author Info & Affiliations
    Published May 30, 2025
    DOI: 10.1056/NEJMoa2501912
    Copyright © 2025

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information research only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options, which are relevant and specific to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

New drug for platinum resistant ovarian cancer

Multiple new drugs have been developed lung and breast cancers over the last decade.

But only a few new drugs have been approved for ovarian cancers in the past decade.

Drugs like Olaparib and Niraparib – which have been approved for ovarian cancers recently – are maintenance drugs used after chemotherapy rather than used as an upfront treatment .

So it is very good news that a brand new drug is likely to enter the market in the near future.

The new drug is called Relacorilant.(Rela).

It has been tested in ovarian cancers which have become resistant to the platinum drugs.

Platinum drugs are the standard of care ovarian cancers and most other drugs do not work very well once ovarian cancers have become resistant to carboplatin or cisplatin (platinum resistant ovarian cancers).

So it is very good news that we may have a new option now for this group of patients with platinum resistant ovarian cancers.

Early phase drug trial results of Rela in 2023 were promising but not definitive.

Advanced phase 3 trials of Rela have been positive in improving survival (2025).

The study results were due to presented at the prestigious annual meeting of the American Society of Clinical Oncology (ASCO) at Chicago.( June 2025).

Dr Sundar is a member of American Society of Clinical Oncology (ASCO) and has been a member for more than 25 years.

References

1. Relacorilant + Nab-Paclitaxel in Patients With Recurrent, Platinum-Resistant Ovarian Cancer: A Three-Arm, Randomized, Controlled, Open-Label Phase II Study
Nicoletta Colombo et al. J Clin Oncol. 2023.

2. Targeted oncology. News Article. March 31, 2025. Relacorilant Extends Survival in Platinum-Resistant Ovarian Cancer Mar 31, 2025 . By Jordyn Sava. Fact checked by: Jason M. Broderick

3. ROSELLA: A phase 3 study of relacorilant in combination with nab-paclitaxel versus nab-paclitaxel monotherapy in patients with platinum-resistant ovarian cancer (GOG-3073, ENGOT-ov72).

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information research only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options, which are relevant and specific to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Can applying some electric current make chemotherapy work better in pancreatic cancer ?

Yes !

Applying electricity to tumours can help to improve control of pancreatic cancer.

The procedure is called TTfFields.

The procedure is not invasive.

The procedure uses low-energy electricity which impedes cancer cells’ ability to grow and divide.

The procedure is done alongside standard chemotherapy .

The TTFields electric treatments has already been tested and has shown promise in brain tumours and lung cancers.

A study presented at the Chicago ASCO meeting shows better survival in patients who had TTFields electricity in addition to their usual chemotherapy regimen of gemcitabine and abraxane (nab-paclitaxel) for pancreatic cancer.

The study data was presented at the prestigious annual meeting of the American Society of Clinical Oncology (ASCO) at Chicago.

Dr Sundar is a member of American Society of Clinical Oncology (ASCO) and has been a member for more than 25 years.

References

  1. Tumour treating fields therapy for glioblastoma: current advances and future directions. British Journal of Cancer volume 124, pages 697–709 (2021)
  2. Weinberg U, Farber O, Giladi M, Bomzon Z, Kirson ED. Tumor treating field concurrent with standard of care for stage 4 non-small cell lung cancer (NSCLC) following platinum failure: Phase III LUNAR study. [abstract]. ESMO, October 2018. Ann Oncol. 2018;29:viii543. doi: 10.1093/annonc/mdy292.120.
  3. Lancet oncology. Tumor Treating Fields therapy with standard systemic therapy versus standard systemic therapy alone in metastatic non-small-cell lung cancer following progression on or after platinum-based therapy (LUNAR): a randomised, open-label, pivotal phase 3 study.
  4. Wiki. Alternating electric field therapy.
  5. PANOVA-3: Phase 3 study of tumor treating fields (TTFields) with gemcitabine and nab-paclitaxel for locally advanced pancreatic ductal adenocarcinoma (LA-PAC) .

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information research only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options, which are relevant and specific to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Hormone tablet Abiraterone for prostate cancer treated with curative intent

Prostate cancer can be treated with curative intent if it is localised to pelvis.

But in patients with high risk cancers, additional treatments might be needed to improve the odds of controlling the cancer.

Abiraterone is one such add-on treatment that has been shown to improve long term outcomes in a large UK trial.

Unfortunately the drug, abiraterone, even though it is much cheaper now, is not widely available in the UK National Health System ( NHS).

Now an AI (artificial intelligence) test has been developed which selects better those patients who are likely to benefit from Abiraterone.

Hopefully the test will become available for routine use in the near future.

The study data was presented at the prestigious annual meeting of the American Society of Clinical Oncology (ASCO) at Chicago.

Dr Sundar is a member of American Society of Clinical Oncology (ASCO) and has been a member for more than 25 years.

References

BBC news. Hugh Pym and Ian Atkinson. Men denied life-extending prostate cancer drug

UCL. AI test to determine best prostate cancer treatment could save lives and money. 30 May 2025.

Daily Telegraph. Give prostate cancer patients drug that halves risk of death, NHS told.

SUN Newspaper.

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information research only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options, which are relevant and specific to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Can some advanced kidney cancer patients be managed by wait and watch only ?

Yes !

When the cancer is advanced , the natural inclination of doctors and patients is chose immediate therapy .

This is the logical and correct thing to do in many cancer patients.

But there are exceptions!

For example, it is well known that some advanced kidney cancer patients can be managed by “active surveillance” or “wait and watch policy” ONLY without any immediate cancer treatment.

A study presented at a Cancer meeting in Chicago confirms that this approach is safe and feasible in “carefully selected” patients.

The study patients who were managed by “active surveillance” or “wait and watch policy” ONLY had preservation of quality of life compared to patients on cancer treatments.

This approach is reassuring but this approach is not for everyone; the study is about kidney cancer patients only. Not other cancers. Patients do need to make an informed choice after discussing the option with their oncologists.

The study data was presented at the prestigious annual meeting of the American Society of Clinical Oncology (ASCO) at Chicago.

Dr Sundar is a member of American Society of Clinical Oncology (ASCO) and has been a member for more than 25 years.

References

American Society of Clinical Oncology (ASCO) 2025. Real-world quality of life (QOL) in patients (pts) with metastatic renal cell carcinoma (mRCC) on active surveillance (AS) in the ODYSSEY prospective observational study. Publication: Journal of Clinical Oncology.

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information research only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options, which are relevant and specific to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

More pancreatic cancer patients may benefit from immunotherapy

Immunotherapy has revolutionised cancer treatment over the last few years . But, sadly, not all cancer patients derive benefit from the costly immunotherapy drugs. 

For instance, almost, all advanced kidney or skin melanoma cancer patients are eligible to try immunotherapy. But only about 1% of patients with pancreatic cancer are at present eligible for immunotherapy .

A new study suggests more people with pancreatic cancer may be eligible for immunotherapy. 

The preliminary data from a good quality early study (randomized phase II trial) is interesting.

The study compared treatment with gemcitabine (G) and nab-paclitaxel (N) with and without dual immunotherapy treatment with durvalumab (D) and tremelimumab (T) as 1st-line therapy in patients with advanced pancreatic cancer. 

In this study, only a subset of patients derived benefit from the dual combination therapy. 

Subsequent molecular and genetic analysis showed that the presence of certain gene mutations (≥2 DDR) was strongly associated with benefit from the combination of chemotherapy with dual immune checkpoint inhibitor therapy. 

These intriguing exploratory data analysis needs confirmatory data before the combination therapy become the standard of care for advanced pancreatic cancer patients.

The study data was presented at the prestigious annual meeting of the American Society of Clinical Oncology (ASCO) hosted at Chicago.

Dr Sundar is a member of American Society of Clinical Oncology (ASCO) and has been a member for more than 25 years.

References

American Society of Clinical Oncology (ASCO) 2025: Concurrent mutations in DNA damage repair genes BRCA1, POLE, ATM and FANCA to predict overall and progression-free survival for patients (pts) with metastatic pancreatic ductal adenocarcinoma (mPDAC) treated with chemotherapy in combination with dual checkpoint inhibition in the CCTG randomized PA.7 trial.

Evaluating Mismatch Repair Deficiency in Pancreatic Adenocarcinoma: Challenges and Recommendations. Clin Cancer Res (2018) 24 (6): 1326–1336.

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information research only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options, which are relevant and specific to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Immunotherapy makes advanced head and neck cancer patients live longer

Immunotherapy has revolutionised the care of many patients with kidney, bladder, skin and various other cancers.

Now a UK led study has shown that given the immunotherapy drug- pembrolizumab – before and after surgery– makes people live substantially longer.

Pembrolizumab is a very costly drug with limited affordability in developing countries.

In western countries, only people with private medical insurance or people having a publicly funded health systems such as NHS can afford it.

The fascinating immunotherapy data was presented at the prestigious annual meeting of the American Society of Clinical Oncology (ASCO) at Chicago.

Dr Sundar is a member of American Society of Clinical Oncology (ASCO) for more than 25 years.

References

  1. BBC News. Breakthrough cancer drug doubles survival in trial. Philippa Roxby
    Heath Reporter. May 2025.
  2. American Society of Clinical Oncology (ASCO) 2025: Neoadjuvant and adjuvant pembrolizumab plus standard of care (SOC) in resectable
    locally advanced head and neck squamous cell carcinoma (LA HNSCC): Exploratory
    efficacy analyses of the phase 3 KEYNOTE-689 study    . ( Distant Metastasis-Free Survival (DMFS) data:
    Median DMFS was 51.8 months with pembrolizumab + SOC versus 35.7 months with SOC (HR 0.71, 95% CI 0.56–0.90).
    Estimated DMFS rate at 36 months was 59.1% versus 49.0%, respectively. )
  3. American Association for Cancer Research (AACR) Annual Meeting. 2025. Addition of Perioperative Pembrolizumab to Standard of Care in Newly Diagnosed Locally Advanced Head and Neck Cancer.
  4. Pembrolizumab With or Without Chemotherapy in Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma: Updated Results of the Phase III KEYNOTE-048 Study.

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information research only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options, which are relevant and specific to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

How long can a man with aggressive prostate cancer live?

Many people were shocked by the news that president Joe Biden, aged 82, has been diagnosed with aggressive prostate cancer.

Prostate cancer is quite common in men in their eighties. Nearly two third of men in eighties would have prostate cancer and most of these men do not die of prostate cancer! This is because lot of the cancers in elderly men are low to medium risk.

But men who develop aggressive prostate cancer are at higher risk of death from prostate cancer. Aggressive prostate cancer can spread to bone and other organs.

It has to be pointed out that aggressive prostate cancer is not immediately terminal in vast majority of men, even if the cancer has spread to bone.

With modern hormone treatments, men can have a prognosis of many years.

References

  1. BBC. Joe Biden diagnosed with ‘aggressive’ prostate cancer
  2. CRUK. Prostate Cancer incidence statistics .
  3. CRUK. Prostate cancer survival statistics.
  4. NEJM. Apalutamide for Metastatic, Castration-Sensitive Prostate Cancer.
  5. Lancet. Abiraterone acetate plus prednisolone with or without enzalutamide for patients with metastatic prostate cancer starting androgen deprivation therapy: final results from two randomised phase 3 trials of the STAMPEDE platform protocol.

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information research only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options, which are relevant and specific to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

The battle of weight loss drugs: which is better? Mounjaro versus Ozempic.

Mounjaro is the winner !

The question has been answered by a high quality trial published in the premier medical journal ( New England Journal of Medicine).

Mounjaro is the winner !

Mounjaro is the brand name of the weight loss drug called Tirzepatide.

Mounjaro has come out on the top when it was compared to the other popular weight loss drug called Ozempic.

Ozempic is the brand name of the weight loss drug called semaglutide. Wegovy is another brand name for semaglutide .

A total of 751 participants were invoked in this trial . The trial was conducted very recently between April 2023, and November 2024.

Nearly 20% of those having Mounjaro injections had lost at  least 30% of their weight but only about 7% of people having Ozempic/ Wegovy injections lost that amount of weight.

Remember- the weight loss injections are not a one time silver bullet. Most people put the weight back on when they stop the injections. 

A healthy diet remains a very important part of weight loss.

References

  1. NEJM Tirzepatide as Compared with Semaglutide for the Treatment of Obesity. L.J. Aronne and Others. DOI: 10.1056/NEJMoa2416394 | May 11, 2025.
  2. Guardian. People who stop weight loss drugs return to original weight within year, analysis finds (Research raises questions about long-term treatment of and support for people using weight loss drugs). Anna Bawden Health and social affairs correspondent in Málaga. Wed 14 May 2025 20.00 BST

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information research only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options, which are relevant and specific to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Are whole-grain foods healthier than refined-grain foods like white rice, bread and pasta?

Yes !

Whole grains are beneficial . They

  • help to control blood sugar levels 
  • keeps you fuller for longer, Young says.

There is a very good article in Guardian Newspaper.

Guardian: Are whole-grain foods really healthier?

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information research only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options, which are relevant and specific to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Can too much vitamins harm the body ?

Absolutely Yes. Vitamins can cause harm.

Vitamins are very essential for life.

But too much of vitamins is bad.

You can buy paracetamol in a supermarket and it (rightly) comes with a big list of side effects .

You can freely buy various vitamins and supplements in supermarkets and none of them come with any warning what so ever.

Because vitamins are heavily promoted over Social media, newspapers, TV, and internet, many people think vitamins are safe and good. So people overindulge hoping for more benefits. But taking too much of vitamins is risky and can cause health problems due to Hypervitaminosis.

A recent article in Guardian points out the risks from taking too much of vitamin supplements. A man took too much of vitamin B6 and this resulted in damage to his nerves!

So be very careful with extra vitamins and supplements. Check whether you need the supplements at all. Try natural products rather than factory produced artificial supplements.

Reference

Guardian newspaper: Simon never linked the pain in his hands and feet to multivitamins – but a pathology test did. Natasha May and Sharlotte Thou. Published Sat 4 Jan 2025 19.00 GMT. Last modified on Sun 5 Jan 2025 01.55 GMT

Wiki. Hypervitaminosis

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information research only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options, which are relevant and specific to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice.

The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Is dark chocolate good for You ?

Is dark chocolate good?

And is milk chocolate bad?

The answer to both the question is YES.

A recent paper published in British Medical Journal (BMJ) found that “people who consumed ≥5 servings/week of dark chocolate showed a significantly LOWER risk of developing diabetes”.

The study also found that eating milk-chocolate was bad. Milk-chocolate was associated with weight gain, which is not surprising to everyone.

Any study relating to “health benefits of food and drinks” always needs a healthy dose of scepticism because of commercial industry.

But the beneficial effect of dark chocolate found in this study aligns with previous findings and more research is, of course, needed to clarify and define the mechanisms involved.

So add more dark chocolate to the Christmas hampers !

Share your dark chocolate with colleagues and spread the good will !

References

BMJ 2024: Chocolate intake and risk of type 2 diabetes: prospective cohort studies. BMJ 2024; 387 doi: https://doi.org/10.1136/bmj-2023-078386 (Published 04 December 2024). BMJ 2024;387:e078386

BMJ 2012: The effectiveness and cost effectiveness of dark chocolate consumption as prevention therapy in people at high risk of cardiovascular disease: best case scenario analysis using a Markov model. BMJ 2012; 344 doi: https://doi.org/10.1136/bmj.e3657 (Published 31 May 2012). BMJ 2012;344:e3657

BMJ 2011: Chocolate consumption and cardiometabolic disorders: systematic review and meta-analysis. BMJ 2011; 343 doi: https://doi.org/10.1136/bmj.d4488 (Published 29 August 2011). BMJ 2011;343:d4488

BMJ 2023. Christmas 2023: Champagne problems. Chocolate brownies and calorie restriction: the sweetest paradox? BMJ 2023; 383 doi: https://doi.org/10.1136/bmj.p2585 (Published 20 December 2023). BMJ 2023;383:p2585

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

How common is prostate cancer in men under 50?

Sir Chris Hoy, who is six-time Olympic cycling champion stunned the British public recently by revealing that that he has stage 4 incurable prostate cancer.

It was even more shocking because of his young age. He is only 48 years old !

Naturally, many men under 50 yrs would be concerned.

According to CRUK statistics “1 in 6 men in UK will be diagnosed with prostate cancer”.

But majority of cancers occur in men 60 yrs and above. The peak age for prostate cancer is in the 75-79 age range. Prostate cancer is very uncommon before age of 50.

So in most men, screening for prostate cancer is not recommended before the age of 50.

There are some exceptions to this age limit of 50. For example, men with black ethnicity or those with a family history of prostate cancer are at a higher risk. These men can consider requesting a PSA test in their mid 40s.

Please note prostate cancer screening does NOT result in better lives for everyone. Screening has its benefits but it also has drawbacks .

A cancer diagnosis is terrifying but it is important to note that NOT Everyman with prostate cancer will die due to prostate cancer. Lot of men with early prostate cancer will die of something else. Moreover, treatment for early prostate cancer has significant side effects.

That is why every man is NOT routinely and automatically offered screening by their GP surgery in UK.

Even though routine PSA testing is not offered on the NHS, as mentioned in the NHS website “Men aged 50 or over can ask their GP for a PSA test, even if they do not have symptoms”. 

References

1. BBC news. Prostate cancer symptoms and treatment: What to check for.

2. BBC news. NHS to review prostate cancer testing after Chris Hoy call for change

3. NEJM. Fifteen-Year Outcomes after Monitoring, Surgery, or Radiotherapy for Prostate Cancer

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Prostate cancer : Surgery versus Radiotherapy

The question of whether to chose surgery or radiotherapy is a difficult decision for most patients with early prostate cancer.

Adding to this confusion is the option of wait and watch policy followed by delayed treatment (if needed) as supported by PROTECT trial.

A high quality UK trial called PACE-A compared surgery versus Radiation in men with low- to intermediate-risk localised prostate cancer.

At 2 years , the study found more people in surgery group reported using more urinary pads and also more sexual problems than radiotherapy group. But the surgery group reported fewer bowel problems than radiotherapy group.

At present, efficacy is expected to be equivalent between two modalities and long term results in term of efficacy is eagerly awaited

Further more, long term data needed in terms of toxicity . This is because some surgery related side effects tend to remain stable whereas some radiotherapy side effects can increase over time. Particularly relevant is the risk of radiation induced cancers can increase over time time . This would be relevant for slightly younger people (eg 60s) who have longer life expectancy compared to elderly people ( eg 80s) .

Also radiation could be used as salvage therapy ( kept as reserve just in case if cancer comes back after surgery ). Whereas if radiation is given upfront, then surgery as second option is usually not a viable option. The caveat is the most intermediate risk cancer patients do not have a relapse after 1st line therapy.

Reference

European Urology Journal: Radical Prostatectomy Versus Stereotactic Radiotherapy for Clinically Localised Prostate Cancer: Results of the PACE-A Randomised Trial.

NEJM Protect trial . Fifteen-Year Outcomes after Monitoring, Surgery, or Radiotherapy for Prostate Cancer.

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

New treatment regimen for bladder cancer

Giving chemotherapy before surgical removal of bladder for invasive cancer is the current standard of care.

Immunotherapy is often used in later stages of treatment for bladder cancer. Now it is being tested in early bladder cancers.

A new study has found that adding immunotherapy drug ( Durvalumab) to existing standard treatment improves the survival outcomes .

Reference

NEJM: Perioperative Durvalumab with Neoadjuvant Chemotherapy in Operable Bladder Cancer.

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

New drug approved for ovarian cancer

The European Medical Agency has approved a new drug for Ovarian cancer.

It is not for everyone though !

The drug is called mirvetuximab soravtansine (Brand name: Elahere).

It is approved for people whose cancer has a got a target called folate receptor (“folate receptor α-positive” cancers).

It is to be used in people who had one to three prior chemotherapy treatment regimens.

Reference

ESMO news. EMA Recommends Granting a Marketing Authorisation for Mirvetuximab Soravtansine

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Depression and Exercise

Can exercise help depression?

Absolutely, Yes

A study which analysed multiple other studies reports that “Exercise such as walking or jogging, yoga, and strength training were effective in treatment of depression”; the more intense the exercise, better the effect !

The study authors say that “Yoga and strength training were particularly well tolerated” .

The paper published in BMj concludes “Exercise can be considered alongside psychotherapy and antidepressants as core treatments for depression”.

References

1. Effect of exercise for depression: systematic review and network meta-analysis of randomised controlled trials | The BMJ

Can some very early bladder cancer patients avoid BCG treatment?

Yes

Recent Japanese trial data suggests that selected patients can be managed by “wait and watch” policy alone .

Reference

1. Trial design: JCOG1019: An Open-label, Non-inferiority, Randomised Phase 3 Study Comparing the Effectiveness of Watchful Waiting (WW) and Intravesical Bacillus Calmette-Guérin (BCG) in Patients (Pts) with High-grade pT1 (HGT1) Bladder Cancer with pT0 on the 2nd Transurethral Resection (TUR) Specimen

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Would AI (artificial intelligence) change the treatment of cancer patients?

Artificial intelligence is the current fashionable technology for investors.

Artificial intelligence is getting incorporated in our daily life.

AI is hyped everywhere .

Would AI make a difference in diagnosis and treatment of cancer patients?

Yes, it will play an important role in choosing the right treatments for individual cancer patient.

At present, a blanket treatment approach is used where subgroups of patients are treated in the same way. Not everyone responds to a particular cancer treatment and some people would develop resistance after an initial response to a particular treatment.

AI can help to move from this blanket treatment approach for whole group of patients

AI can help us move towards a personalised approach; it can help us to predict resistance and response to a particular treatment

AI can help in new drug development.

AI seems to the future

A word of caution. AI is not ready for routine clinical use yet. AI Algorithms need to be validated before day to day clinical use.

ESMO 2024 Barcelona Session

Reference

Annals of Oncology. How AI will transform cancer care.

New treatment option for liver cancer

Data presented at the ESMO Congress 2024 (Barcelona, 13–17 September) shows that adding Lenvatinib (tablets) and Pembrolizumab (immunotherapy infusion) to standard treatment has the potential to improve prognosis.

The trial was done in intermediate stage patients.

Adding the combination of Lenvatinib and Pembrolizumab to the other standard treatment TACE seems to work.

The response rates are better with combination and early results are promising but the data is still immature.

Another caveat is that this combination was previously tested in the advanced setting. The combination of Lenvatinib and Pembrolizumab did NOT improve survival in the advanced cancer patient group.

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Immunotherapy for curative treatment of Cervical cancer

Updated Data presented at the ESMO Congress 2024( Barcelona, 13–17 September) confirms benefit of adding immunotherapy to combination of chemotherapy and radiotherapy for treatment of cervical cancer.

For nearly twenty years, chemo- radiation, which is the practice of giving chemotherapy at the same time as radiotherapy, was the standard of care.

Last year, early results from a large trial suggested that adding immunotherapy to chemo-radiation would improve outcome .

Updated results confirm that the additional immunotherapy is of significant benefit.

Reference

Lancet. Pembrolizumab or placebo with chemoradiotherapy followed by pembrolizumab or placebo for newly diagnosed, high-risk, locally advanced cervical cancer (ENGOT-cx11/GOG-3047/KEYNOTE-A18): overall survival results from a randomised, double-blind, placebo-controlled, phase 3 trial.

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

New standard of care for advanced anal cancer patients

Data presented at the ESMO Congress 2024 (Barcelona, 13–17 September) demonstrated the potential of combining immunotherapy with chemotherapy for advanced anal cancer patients.

Addition of immunotherapy drug retifanlimab to the chemotherapy combination carboplatin and paclitaxel significantly improved the outcomes.

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

New treatment option for advanced prostate cancer patients

Advanced prostate patients were treated with hormone injections only in the past. When these advanced cancer patients were no longer responding to those hormone injections, tablets such as Enzalutamide , Apalutamide and Abiraterone were added to the hormone injections.

A new combination has become available for use in these patients.

Data presented at the ESMO Congress 2024 (Barcelona, 13–17 September) demonstrated the potential of combining Enzalutamide and Radium 223 injections.

The combination Enzalutamide and Radium 223 injections was better than Enzalutamide tablets alone.

The combination is likely to become a standard of care for these patients.

The only caveat is that a lot of advanced cancer patients are nowadays treated with hormone injections and tablets upfront. This trial data does not directly apply to these patients.

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

New treatment option for patients with Gestational trophoblastic tumours (GTT)

Gestational trophoblastic tumours (GTT) are a rare but pregnancy related tumours arising from the placenta

Methotrexate chemotherapy is the sstandard treatment option for low risk GTT tumours .

A new regimen was unveiled at the ESMO European Society of Medical Oncology Congress-2024, Barcelona.

A French trial reported promising results using combination of chemotherapy ( Methotrexate) and immunotherapy (Avelumab)

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

How to overcome resistance to Olaparib and other similar PARP inhibitors ?

Olaparib and similar drugs have revolutionised the treatment of a sub-set of patients with BRCA gene mutations ( eg Ovarian, Prostate, Breast cancers).

But patients can develop resistance to these drugs.

At the ESMO European Society of Medical Oncology Congress-2024, Barcelona), ways to overcome this resistance was discussed.

Targeting the Enzymes USP-1 and POLQ seems to overcome resistance.

The future looks promising!

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

ESMO update on Thymus tumours

Tumours of Thymus are rare. So clinical data is usually spare. Hence they do not feature prominently in International conferences.

So it is interesting and a welcome gesture that ESMO dedicated a morning session to Thymic tumours. (ESMO European Society of Medical Oncology Congress-2024, Fira Barcelona).

Understandably, in a conference hall meant for thousands of delegates only a few hundreds turned up for the rare thymic tumours ( as delegates attended the 12 other massive halls with simultaneous sessions for common cancers such as prostate, breast , bowel etc).

The relevant updates from this session are: 

  1. Surgical resection where feasible is the best treatment.
  2. in selected cases , post-operative radiotherapy can be considered 
  3. Routine adjuvant chemotherapy after complete surgical excision for early cancers is NOT indicated 
  4. Thymic cancers are chemo-sensitive and they have the potential to turn inoperable cancers to operable cancers.
  5. Platinum and Anthracycline combination chemo regimens have the best response rates.
  6. Immunotherapy and Molecular targeted therapy are possible options in those resistant to platinum drugs in addition to other non-platinum chemotherapy drugs .

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Is radiotherapy needed for all lymphoma patients after completing a course of chemotherapy?

In previous decades, radiotherapy was routinely used to consolidate remission after completion of chemotherapy in Lymphoma patients.

Chemotherapy alone can cure a lot of these patients. Radiotherapy can be associated with long term side effects even 10 years after completion of treatment.

So increasingly there is a tendency to omit radiotherapy in those lymphoma patients who had responded extremely well to chemotherapy alone.

Long term trial results, in a group of lymphoma patients who had mediastinal (chest) lymphoma, confirms that radiotherapy can be safely omitted in those patients who had excellent response to chemotherapy alone.

Reference

Omission of Radiotherapy in Primary Mediastinal B-Cell Lymphoma: IELSG37 Trial Results | Journal of Clinical Oncology

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

New drug for and 2nd and 3rd line treatment of Kidney cancer

Advanced Kidney cancer can be kept under control for long periods with current treatments.

Combination of immunotherapy and agents targeting VEGF are commonly used in 1st line treatment of advanced Kidney cancers.

For those patients who cancers stop responding to these above treatments, there is good news.

A new agent targeting cancers in a different way has become available recently and updated results are very encouraging.

This new drug called Belzutifan targets a different weak spot in the cancer. Belzutifan has shown better cancer control rates when compared to another drug called Everolimus.

Belzutifan results are being presented at ESMO congress in Barcelona

Belzutifan will become a standard of care in this setting now

Reference

ESMO news. Belzutifan Shows a Significant Benefit Over Everolimus in Patients with Advanced Clear Cell RCC After Both ICI and Antiangiogenic Therapies

NEJM Belzutifan versus Everolimus for Advanced Renal-Cell Carcinoma

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Should quotas be used to increase women representation?

In areas where women representation has been traditionally poor, Quotas have been suggested as a quick and easy fix.

But quotas do have their limitations and can lead to unintended consequences.

Read the BMJ letter and post your views through rapid response.

Article: Womens representation and limitations of quotas

Free to access link: http://bmj.com/cgi/content/full/bmj.q1629?ijkey=MSTzILqzKZNt2UR&keytype=ref

Disclaimer: The views expressed in this blog represent the author’s personal views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is NOT previewed, commissioned or otherwise endorsed by any organisation that the author is associated with.

New immunotherapy treatment option for Liver cancer

Immunotherapy has dramatically improved the prognosis of skin cancer patients and has made significant improvement in prognosis of kidney, lung, uterus and bladder cancer patients .

Advanced liver cancer is notoriously difficult to treat and prognosis is often poor.

Now a widely used combination immunotherapy therapy treatment has been found to improve the prognosis of liver cancer patients.

Patients with inoperable, previously untreated, liver cancer had significantly longer overall survival with the combination of nivolumab plus ipilimumab compared with former standard-of-care with lenvatinib or sorafenib.

Doublet Immunotherapy (nivolumab plus ipilimumab ) is a standard of care now in primary liver cancer ( HCC: hepato cellular carcinoma ).

References

1. ASCO 2024. Nivolumab (NIVO) plus ipilimumab (IPI) vs lenvatinib (LEN) or sorafenib (SOR) as first-line treatment for unresectable hepatocellular carcinoma (uHCC): First results from CheckMate 9DW. Abstract LBA4008

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.