DYNAMIC - Circulating Tumor DNA to decide Adjuvant Chemo in Stage II Colon Cancer | LEVEL - HARD

Vinay Prasad, MD MPH; Physician & Associate Professor
Google Scholar: scholar.google.com/citations?...
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Academic Publications: www.vinayakkprasad.com/papers
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Пікірлер: 47

  • @jeffk8900
    @jeffk89002 жыл бұрын

    I think your message would bet across better if you reduce your presence in the video. I think if you make slides bigger and put yourself in smaller video capture, it will improve the message and take your celebrity out of the picture. Message is the most important, for practice and for patients.

  • @NurburgringUP
    @NurburgringUP2 жыл бұрын

    Loved this analysis. Glad to have oncology back on the channel!

  • @teresabenson3385
    @teresabenson33852 жыл бұрын

    Thank you for this. I train clinicians in EBM, and these videos are very helpful for walking them through the practical application of critical appraisal-- and knowing why even the dreaded statistics class is important.

  • @Fruitcookieandmilk
    @Fruitcookieandmilk2 жыл бұрын

    Yes please make slides bigger cuz likely most of us are watching on cell phone while doing our cardio before getting back on ehr

  • @kylewalsh393
    @kylewalsh3932 жыл бұрын

    I enjoy the analysis with the passion!

  • @cibarmartin
    @cibarmartin2 жыл бұрын

    Just bought your book, thanks VP!

  • @jamesparry1547
    @jamesparry15472 жыл бұрын

    My advice at this of the game, release everything you know that your to scared to publish ASAP. Also turn on your sound , we are at a stage where if the truth doesn't come out soon the blood stained hands of medical intervention will never be clean again.

  • @saralotti7174

    @saralotti7174

    2 жыл бұрын

    That’s what they want imo. So they can replace the white costumed doctor distributors with artificial intelligence programs and diagnostics that cannot be swayed by “for profit” “consensus” and unethical greed. The angelic white coats cannot hide the piracy plummeting our health wealth for their own bounty. Pirates must walk the plank. Maybe they should learn to code😉

  • @dedetudor.

    @dedetudor.

    2 жыл бұрын

    James... Please see latest post on Russell Brand... He has video of Klaus Schwab and Albert Bourla speaking at the WEF. Then see the latest post on DarkHorse with Brett and Heather Weinstein. Also David Martin World on yt. Latest post covers gov 2021 Tabletop Exercise for pox and other pathogens. Very very important. Please spread the word.

  • @simonac4811

    @simonac4811

    2 жыл бұрын

    @@dedetudor. I'll look it up. Thank you

  • @sm-ed3kw

    @sm-ed3kw

    2 жыл бұрын

    @@dedetudor. Russel brand is clearly controlled opposition, check out Hugo talks video on him, he's heavily censored on theytube so go to his website

  • @dedetudor.

    @dedetudor.

    2 жыл бұрын

    @@sm-ed3kw anyone can say that but they're wrong. I know Russell's history. He openly has spoken about it. He puts out the information and demands everyone be allowed to think for themselves. Make their own decisions. Make their own choices. Not to be coerced.

  • @danielnavarodrigues9175
    @danielnavarodrigues91752 жыл бұрын

    Thanks for this awesome video, Vinay.

  • @jeffk8900
    @jeffk89002 жыл бұрын

    Implementation of the rule of thirds would really set up the visual on this.

  • @DamienKee

    @DamienKee

    2 жыл бұрын

    Video quality and production are top notch, but agree with layout criticism. 2 thirds slides, move Vinay to the right third (which moves the microphone out). (The academic content is as insightful and thought provoking as we've come to expect.)

  • @ninjagirl226
    @ninjagirl2262 жыл бұрын

    Ok this is outside my field substantially, and I don't understand anything so I will just ask my question. How reliably can be detect these ctDNA sequences? What are the copies/uL in the sample matrix of the target sequences? From my experience trying to detect them in plasma it's not really easy and we were targeting high abundance mutations.

  • @casselfriemel
    @casselfriemel2 жыл бұрын

    Thank you for these videos Vinay. I am an Oncologist in Iowa, own my own business, and treat all cancers so when I attend ASCO virtually, I am just trying to gulp down the massive amount of info coming from the fire hose, and having a devil's advocate I can stream to put things into context is sublime.

  • @JCResDoc94
    @JCResDoc942 жыл бұрын

    another gr8 entry. thr is no reason for it o be like this. it isnt even cheaper. at a minimum we have to keep pointing it out. ppl dont want to be bad at thr job, especially if the money and accolades will be the same. this is important. -JC

  • @jeffk8900
    @jeffk89002 жыл бұрын

    Maybe put slides in the full video and reduce your video.

  • @jose6183
    @jose61832 жыл бұрын

    How strange there is audio from my country. Maybe you guys are being selectively censored depending on the location

  • @sm-ed3kw

    @sm-ed3kw

    2 жыл бұрын

    Audio is fine in the UK

  • @indianasb59
    @indianasb592 жыл бұрын

    LOL !!! At least a commercial played on the ‘tap to retry’ Hahahaha

  • @mikelambert7256
    @mikelambert72562 жыл бұрын

    hack yeah!!! ONC IS BACK!!!

  • @Neillionaire
    @Neillionaire2 жыл бұрын

    I have no audio issues either playing straight from my phone or with wireless headphones (and I get audio on both the right and left channels), so I'm unsure why others are having issues.

  • @slomo1716
    @slomo17162 жыл бұрын

    YOU sure look handsome with a cleanly shaven face and great hair and a NASA T-SHIRT!!!!

  • @oldschool8292
    @oldschool82922 жыл бұрын

    No sound problem for me

  • @JCResDoc94
    @JCResDoc942 жыл бұрын

    *i have that shirt!* i think a lot of ppl do. -JC

  • @mattp1913
    @mattp19132 жыл бұрын

    Would one say this about other blood tests, such as grail?

  • @Soundsaboutright42
    @Soundsaboutright422 жыл бұрын

    Audio is back

  • @jeffk8900
    @jeffk89002 жыл бұрын

    Can’t see the tables and figures that you are putting up.

  • @cathyburkart9395
    @cathyburkart93952 жыл бұрын

    No sound!

  • @qianshi5489
    @qianshi54892 жыл бұрын

    Totally agree the NI margin is very big

  • @mballer
    @mballer2 жыл бұрын

    Is it better to avoid colon cancer? Consider.

  • @indianasb59
    @indianasb592 жыл бұрын

    Did you get immediately blocked?!?

  • @nasagolfer
    @nasagolfer2 жыл бұрын

    Love the NASA meat ball shirt!!!

  • @mballer

    @mballer

    2 жыл бұрын

    Hmm.

  • @JohnDoe-cb5nb
    @JohnDoe-cb5nb2 жыл бұрын

    Didnt quite understand the criticism. Seemed quite tangential to the crux of the study that ctdna guided approach especially the ctDNA negative patients can be safely omitted chemo without compromising the outcomes . Yes there are caveats , all of which are listed in the accompanying editorial.

  • @joelpollen

    @joelpollen

    2 жыл бұрын

    I agree that this talk lacked the clarity of message that Vinay usually brings, but I think his core argument was this: If we are already not very good at predicting who will have recurrence, and even in high-risk people the treatment doesn't reduce their risk that much, then proving that your test is no more than 8.5% worse than what we were doing is too low a bar. He points out that the current guidelines for adjuvant chemotherapy are based on low-quality, old data. Plausibly, you could achieve the same outcome as this study (giving chemotherapy to fewer people without reducing DFS rates) by just doing a fresh study of recurrence risk factors and identifying risk factors that were previously thought important but aren't. Or, more provocatively, you could achieve the same results by marketing a new "test" that's really just whatever we're doing now, plus a random number generator (i.e. a coinflip) which excludes some people from the chemo group. The difference is that the latter two would be far cheaper (free, actually) than ctDNA testing. ... Even if you don't agree with this specific critique, I think it's quite clear that there is a worrying trend in medicine of finding an area where there isn't good evidence, then showing non-inferiority (or very marginal benefit) of some wildly expensive alternative against standard of care. Absent a cost-benefit comparsion to all reasonable alternatives, being non-inferior to SOC isn't sufficient to justify using a new (likely patented) product. If your Honda Civic is starting to fail, you could replace it with a Lamborghini, or you could just get a new Honda Civic. And that's quite obviously a better decision. The difference in health care is that people aren't spending their own money.

  • @JohnDoe-cb5nb

    @JohnDoe-cb5nb

    2 жыл бұрын

    @@joelpollen i get it now. Thanks for explaining it. But still see a lot of merit in this trial with a few caveats like do dMMR or T4 needs ctDNA. But be as it may I think ctDNA and MRD assessments are here to stay and as we get more data there utility will further get clarified. I mean we wildly expensive genomics tests like OncotypeDX that are now part of SoC so such technologies will continue to get incorporated.

  • @maxwellkrem2779

    @maxwellkrem2779

    29 күн бұрын

    Simply put, the vast majority of stage 2 colon cancers should not get chemo. Why do we need an expensive new test to maintain that status quo?

  • @teresabenson3385
    @teresabenson33852 жыл бұрын

    Hi, I wanted to share this with my colleagues and trainees, but KZread has it designated as "Restricted"-- and since our corporation has all our laptops locked in KZread Restricted Mode, we are unable to view it. Any chance one of your assistants can bleep out the bad language at the end and try to get it un-Restricted? (I'm guessing it's because of the F-word; the SHINE trial video had "s**t" in there and was not restricted.) Thank you in advance!

  • @dedetudor.
    @dedetudor.2 жыл бұрын

    If you go seeking after the causes of the cancers, it is quite a 🐰🕳. Then we really wouldn't have to be talking about toxic treatments.

  • @mballer

    @mballer

    2 жыл бұрын

    Looks to me to be similar to what happened with stomach ulcers. Treatment was cut them out. Quite profitable. No financial reason to find the cause. Then some guy figured out it was a bacteria but cutting out ulcers continued on. Bacteria are creating chemicals all day long. There are trillions of bacteria that are not being mentioned here.

  • @Think-dont-believe

    @Think-dont-believe

    Жыл бұрын

    Instead of 🐰🕳️just paste it with 🐴🍎 .. no joke look it up 🍎🐴 does what you both said. Fixes the source of tummy and fast. No joke just 😢that’s why they not want peep to use on large scale cause all kinds go bye bye fast

  • @benjclarke5825
    @benjclarke58252 жыл бұрын

    I got exactly 2:13 into this video when I realized I was unqualified to listen further.

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