PinksTachio

In oncology, a side effect is usually just damage. With immunotherapy, it is sometimes a blessing in disguise and evidence the drug is working. A patient of mine has metastatic colorectal cancer. His scans are clean, complete remission, nothing left to see. His tumor was something we call “dMMR”: it had lost its spell-check and piled up thousands of mutations, which made it look alien to his immune system, which is why we only needed a spark to light it up. Thats what we did with dual immunotherapy. A decade ago, chemotherapy bought patients like him about a year. With immunotherapy we tend to see these cases with full remission even in stage 4. Then his liver enzymes climbed: Immune hepatitis, his own immune system overshot and attacked the healthy liver. We paused the treatment and started cortisone watching the results almost on a daily basis. Thankfully they came down, the treatment is still paused. Ideally we will never have to start it again. The immune system essentially has learned his tumor. That memory is why someone can come off treatment and stay in remission.

Hoy, los opositores al MIR aprenderán un concepto de creciente relevancia clínica sobre el estadiaje de la DM tipo 1: Estadio 1 -> autoinmunidad positiva + normoglucemia Estadio 2 -> disglicemia asintomática Estadio 3 -> criterios diagnósticos + sintomas + hiperglucemia.