TAPUR study

[muzzatron]

Following up on a genomics report (47 pages ! Plus 54 min consult) and came across this study (phase 2 basket trial) in the US.

Essentially when exhausting, or before, standard of care options, allows patients to trial off label approved drugs using genomics to identify specific targetable variations, mutations.

Having said that they also trialed solid tumour treatments eg Pembrolizumab in patients with MBC with HTMB,

pubmed.ncbi.nim.nih.gov/338...

Genomics test called guardant360 in the US? ( blood or tissue)

Not universal benefit but for advanced, Metatastic cancers.

In the US insurance driven industry more emphasis on optimum treatment (cost?) ie targeted, precision therapies. Surgeons advocate from 2019.

The not so good in US? Big pharma, free enterprise, price gouging.

The fastest growth of personal debt in US.

ihi.org/insights/crisis-med...

In AU, UK ? Canada? is not socialised but more a safety net for those less well off, by definition private insurance spreads cost amongst a pool. Under huge pressure post Covid but still functioning.

In Canada?, UK, ? Australia, not standard of care but some clinicians can have it done in the public system.

We paid $3300 but now we have an onc part public and has contacts.

If having a biopsy, tissue the more robust.

old-prod.asco.org/research-...

Expensive protocol for non US citizens.🤨

Fortunately Australia has a similar but smaller scale, MoST program.

Australia has highest cancer rate in the world but one of the best survival rates.

Can anyone explain why advanced countries like Australia, New Zealand, Ireland, US have the highest rates but Sudan, South Sudan, Djibouti, Timor Leste have the lowest? (source: Dana - Faber)

Intermittent fasting, ketogenic diet? Metabolic theory, Warburg effect? Sugar? (Blood glucose more likely) . Curcumin? Natural fresh food?

Over 40% lifestyle, diet cancer risk factor but what the government don’t feature is the toxic environment we are exposed to in every day life.

Treatments incorporating metabolic theory are proving alusive but some evidence enhancing chemo, radiation ie traditional .

PET scans show the uptake of glucose by cancer cells, a possible avenue of further research.

Metformin, a diabetic treatment drug, has shown to reduce the risk of most cancers, some more than others. Pub Med - The relationship between Metformin consumption and cancer risk.

Immunology is the other new frontier showing promise , CAR T cell therapy proving effective in autoimmune diseases showing promise in some cancer treatments included with chemo.

I am liking the cancer pod, The moss report, Dr Li, Blaylock, integrative medicine.

On second tier, Fulvestrant. Oral SERD can’t come soon enough. 🙏🏻

Public system only funds CDK4/6 initially ie Ibrance yet it is the AI, Arimadex that invariably fails and combination therapy could be continued with say Verzenio, Fulvestrant as informed by genomics.

An analysis suggested CDK4/6 could be held in reserve thus saving money.

A new concept is not to wait for progression but mix it up, low dose oral chemo etc.

Not likely to be supported in the traditional cookie cutter standard of care Oncologist cohort.

Do no harm has frightened many, the best interests of the patient is my preference.

I personally want every evidence based rabbit hole explored for my dear partner.

Side effects 🤬

Has anyone used, know of infra red sauna?

The guru’s claiming special insight with a book, subscription deal stay clear of.

Bless.

[muzzatron]

Linda at TAPUR was very helpful. Thanks Linda.

[NPmary]

muzzatron, You shared so much information and so many excellent questions.I would like to respond to one:

"Can anyone explain why advanced countries like Australia, New Zealand, Ireland, US have the highest rates but Sudan, South Sudan, Djibouti, Timor Leste have the lowest? (source: Dana - Faber)"

My guess is that the answer is complex and mult-factorial. (Disclosure: I am a mid--western US citizen) What comes to mind initially epigenetic and how capitalism,greed, genetics, effects of diet, fast food, plastics, multiple carcinogens we consume and are exposed to in the environment . . . you have my head spinning. I appreciate that.

Question for you: any thoughts on this from Dana-Farber?

Wish you and your partner the best. 🌺 Mary

[Bettybuckets in reply to NPmary]

It could be as simple as the very high rate of melanoma and skin cancers in Australia/NZ are partially due to a large hole in the ozone layer over those countries which no longer protects skin… especially light colored skin. Those African nations have populations with greater amount of melanin protecting their skin from the sun. So they probably have much lower rates of skin cancer compared to white peoples living in Australia. Seems reasonable.

[NPmary in reply to Bettybuckets]

Yes.

[muzzatron in reply to NPmary]

Presumably there was a balloon of skin cancer cases due ozone layer depletion around Oceana but now addressed with elimination of certain refrigerant, cleaning agents. UV going to be high around equator so probably not a good idea for fair skinned folk.

Now we have a looming catastrophe due climate change, +2 deg. Recently reported most of the US senate funded by FF interests as are governments, politicians in most western countries. No need in Russia, Saudi as the government is the fossil fuel industry. Fortunately scientists like Michael Mann, Tim Flannery etc pushed back at considerable personal cost.