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General Discussion

Purple kangaroo

Keytruda

Hi all,
Some great news, in the immunotheraphy world. Pembrolizumab (keytruda) has been FDA approved for those who are MSI high. Not just for colorectal cancer so could be beneficial for many, lets hope the UK catches up very soon. We are making great progress, long may it continue - www.onclive.com/...mismatch-repair-deficient-cancers

CD1966

That is very good news. Now, if only they would bring back Avastin!

Swan

Potentially very exciting, is it likely NICE will approve it now for the same thing?

Juliem1969

Fingers crossed uk approve it too :x:

lynn collier

Hello is keytruda good for secondary liver cancer please :x::x:

Swan

Hi @lynn collier From what I understand it has been or is about to be approved in America for people with secondary liver cancer. In the UK it's is available for some other cancers (skin and lung I think)on the nhs but not bowel. I also think a member of this forum called David Watts is being treated with it but having to pay for it himself and it is very expensive. I don't have any more details but is you put his name into the magnifying glass at the top of the page you will be able to read his posts. All the best love Swan :x::x:

lynn collier

Aww thank you Swan as hubby not having any treatment at moment so hoping for clinical trial if any available hope yr well love lynn :x::x::x:

Swan

Your welcome @lynn collier, my hubby is in the same position. :x::x:

lynn collier

Really Swan can you pm me and tell me bit more please :x::x:

Swan

Thank you for posting that @david watt. Is mismatch repair deficient the same as lynch syndrome ?

david watt

HI @Swan
No Lynch and Mismatch repair completely different. Lynch is like a fault in your genetic code meaning you have a 80% chance of getting one of 10 different cancers at a younger age. Mismatch repair is a feature of some cancers including colon cancer. I think most lynch cancers usually have mismatch repair.

Swan

Thank you @david watt . I'm going to get my husband to ask his oncologist if his cancer features mismatch repair. He has been tested for Lynch hnd does not have it . Good luck with your treatment and hope keytruda becomes available for you on the NHS. Swan

CD1966

Thanks for that info @david watt - hope you are continuing to do well on the Keytruda.

pollypops

Hi @david watt and @Swan, just for clarification, Lynch syndrome is where you have a genetic mutation in one of the 4 mismatch repair (MMR) genes which causes DNA replication errors to occur. So the two are very much related, but not the same. With Lynch you have a lifetime risk of up to 85% of getting bowel cancer and if you are a woman a high risk of endometrial cancer. There are other lynch cancer risks which are much lower including ovary, stomach and small bowel.

Testing for lynch starts with Immunohistochemistry (IHC) after your bowel operation, where they look to see if one of the MMR gene proteins are absent. If one or more are absent, it is possible, but not certain, that you have lynch. Between 12-15% of bowel cancers have an absent MMR gene and 5-7% have Lynch. You then continue on to Micro Satellite Instability (MSI) testing and /or Germline Lynch panel testing. This takes months or more to complete. So, if shortly after your op you get told you do not have lynch it is likely that the initial IHC test showed that you are not MMR deficient and therefore not MSI high too. ...Hopefully Keytruda becomes available for MSI high/ MMR deficient bowel cancer patients soon. Px

Swan

Thanks for the info @pollypols. :x::x: