SHINE - A Bad Study Of Upfront Ibrutinib + BR is optimal in Mantle Cell | ASCO2022 | I explain why

Vinay Prasad, MD MPH; Physician & Associate Professor
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Пікірлер: 46

  • @jdenmark1287
    @jdenmark12872 жыл бұрын

    For those of us that are newer to medical/health professions, it is eminently valuable to have you so clearly articulate the illogical behavior that litters our fields.

  • @nikk3251
    @nikk32512 жыл бұрын

    Hi doc hope you're fine. During the worst of all this nonsense, you have comforted and informed me and I am grateful 🙏 😊💜

  • @suebell5870
    @suebell58702 жыл бұрын

    As someone who lost a brother to mantle cell in 2007, news like this is more than disheartening. What a waste. I agree, no study would have been better than this.

  • @EljinRIP
    @EljinRIP2 жыл бұрын

    Please keep making videos about these issues and writing about them. Also, continue encouraging other doctors to do the same. I am just a layman, but I hate the dark side of medicine. Its issues like this that allow people to believe in things like Ivermectin for COVID because they think they cant trust the medical establishment. And too some extent, they cant. Please keep doing this work and helping to return credibility to medicine.

  • @OrthodoxInquirer

    @OrthodoxInquirer

    2 жыл бұрын

    I'm still taking Ivermectin once a week - 18mg - and with no vax, never caught Covid. I do not trust the medical establishment because even if it doesn't work, it has a safer drug profile than aspirin or Tylenol. Check the Pharmacist's Desk Reference. If it's only placebo, at least it does no harm. My 84 yo mother takes it too, and it's only side effect was that it got rid of her blepharitis. I googled it, and there's a JAMA article from 2014 about it killing demodex mites on the skin and eyelashes. It did that for my mother. My friend's mother died suddenly 2 days after her 2nd Pfz shot in Feb '21, and our piano teacher's 26 yo nephew had a stroke after his. No thank you!

  • @maxwellkrem2779
    @maxwellkrem277925 күн бұрын

    IBR (upfront) vs BR then I (sequential) *should* have been the design, but that doesn't get enough drug prescribed. That's the crux. Agree 110% with your point. Journal is also selling targeted pharma ads, and I think that's why they print these studies. My NEJM shows up faithfully every week, without a paid subscription, no doubt so that the ads get delivered to my doorstep.

  • @bernadettelafave4710
    @bernadettelafave47102 жыл бұрын

    I really get a kick from listening to you !! ❤️ You are laying things out so clearly ..... corruption is everywhere !! People are so easily lead by the nose .....

  • @OrthodoxInquirer
    @OrthodoxInquirer2 жыл бұрын

    Can you figure out at what point during medical school or practice do some doctors get so hardened that they care more about cash from Big Pharma than people's survival? Why do I keep encountering physician after physician who are really, really awful people? I have encountered a few good ones online, like yourself and Dr. John Campbell (actually a doctor of nursing), and a couple in person. It's just that maybe 1 out of 10 are good, and the rest shouldn't be practicing! The entire FDA and CDC are corrupt and that's really not in question anymore. Thank you for bringing this to the attention of other doctors and bringing some heat to the people who designed the study. Something is seriously wrong if a doctor can watch people die without guilt or remorse just so they can finish a study. That's unethical even within the current framework.

  • @willdochicky

    @willdochicky

    2 жыл бұрын

    I had such a terrible experience the last time I went to a doctor that I haven’t been to one again. I can do better than that hack! It was a really bad experience. I was in tears.

  • @dedetudor.

    @dedetudor.

    2 жыл бұрын

    @@willdochicky Christy. I could write a book The size of War and Peace with the same ordeals. It spans the space of time. They get paid regardless and caring is not their forte.

  • @terrileezink7744

    @terrileezink7744

    2 жыл бұрын

    @@willdochicky I have a rare bone disease. I could likewise write a big book of incompetent Dr.s.!! I have been in tears many times. Now...I laugh!!

  • @willdochicky

    @willdochicky

    2 жыл бұрын

    @@terrileezink7744 ❤️

  • @wwjccsd

    @wwjccsd

    2 жыл бұрын

    It’s part of medical school. They desensitize new doctors to see patients not as human beings. Add onto residencies where doctors are treated basically as cheap labor and beaten down. Additionally, ask people coming up through high school or college why they want to be doctors and it’s not to help people but the money. Granted a lot don’t make it but they’ll end up in other parts of medical field (predominately nursing)

  • @sigrid3553
    @sigrid35532 жыл бұрын

    Thank you for this important information! We need doctors like you, going into the details and share it with us.

  • @TheGibby13
    @TheGibby132 жыл бұрын

    Vinay you always shine. Great critique

  • @slamrn9689
    @slamrn96892 жыл бұрын

    Great review of this paper!

  • @MrKrekkie
    @MrKrekkie2 жыл бұрын

    Interesting, thank you.

  • @frmrsepp
    @frmrsepp2 жыл бұрын

    I would love to see a video on your response to Geert van den bossches interview with del bigtree ( I know he is cringe) but geert has been pretty accurate through the whole pandemic. He has some pretty dire predictions coming up and the explaination makes sense to the lay person.

  • @micheleflynn6705
    @micheleflynn67052 жыл бұрын

    sorry, I can't trust the motive's anymore.....when profit supersedes human value....

  • @brettanderson6743
    @brettanderson67432 жыл бұрын

    Thoughts on the French pre-print linking CJD (prion disease) to COVID vaccine.

  • @glorioskiola

    @glorioskiola

    2 жыл бұрын

    I know someone who suddenly died of CJD recently. A 75 year old local doctor, fully vaxxed and boosted. Horrible.

  • @wisenber
    @wisenber2 жыл бұрын

    But why can't Our Lady of Perpetual 18 Thousand Dollars a Month (Ibrutinib) be the default answer? The third generation of BTKi appear to be more targeted and reversible along with less AE. Now if we just had some research on PFS for WM using intermittent rounds of BTKi versus perpetual daily doses. It would be nice to sit out in the sun for a bit while saving 18 grand a month so long as the IgM remained in check.

  • @JCResDoc94
    @JCResDoc942 жыл бұрын

    how can it possibly be asco time already?! time: i dont believe in it. -JC

  • @dickinstheblackcactu
    @dickinstheblackcactu2 жыл бұрын

    PFS → SFP from the prophets of disease (the prophecy my be fulfilled by the profits in such cases).

  • @sarahcesar5813
    @sarahcesar58132 жыл бұрын

    There are two doctors who told me that I must stop taking ibuprofen, but take/drink turmeric or curcumin instead. Alhamdulillah, curcumin and turmeric are some of my ancestors kitchen remedies.. 🙏

  • @jaredkelly5470
    @jaredkelly54702 жыл бұрын

    Damn

  • @georgemead6608
    @georgemead66082 жыл бұрын

    SHINE: AKA polishing a turd?

  • @danieljohnson309
    @danieljohnson3092 жыл бұрын

    Ok, I get that it's a garbage trial, and there always seem to be conflicts of interest. I have a question though - Isn't OS for many B-cell lymphoma patients just plain difficult to accurately determine for a number of reasons, such as 1. The median age of diagnosis of many B cell lymphomas is around 65, there are often other morbidities and life expectancy isn't much longer? 2. These dyscrasias are sufficiently uncommon that simply getting a sample together to study is very difficult? Or maybe I am not seeing this correctly. Finally, what should doctors do with equivocational studies like the SHINE study? Seems to me that more are sure to come, esp. if $$$ is involved and the development of new treatments is sure to increase. BTW I am not a clinician, but am considering it. Thanks.

  • @joelpollen

    @joelpollen

    2 жыл бұрын

    Daniel, here are my thoughts: 1. No, comorbidities aren't a problem. If the treatment you are studying has such a small survivial benefit that it can't cut through the noise of unrelated comorbid deaths, then it's probably not worth studying. In fact, many studies have been able to show an OS benefit in MCL and other B-cell cancers. For example, the trial linked at the end of this comment showed that R-CHOP outperformed FCR on survival in this setting. 2. The SHINE study had 523 patients. That is more than enough to draw conclusions about drug efficacy. Read the paper's statistical analysis plan for details. 3. As Vinay alludes to, many doctors can and will respond by continuing to give BR upfront and ibrutinib upon relapse. MDs at the large academic medical centers will be more likely to move to an overly aggressive treatment model a la this study, but most patients are actually not treated at such centers. www-nejm-org.ezproxy.library.wisc.edu/doi/10.1056/NEJMoa1200920?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200www.ncbi.nlm.nih.gov

  • @danieljohnson309

    @danieljohnson309

    2 жыл бұрын

    Hmmm well, thanks for the reply, Joel. So many TX options for these Lymphomas, and so many possible drug combinations too; it's unfortunate that $ and energy was spent this way.

  • @DP-PhD
    @DP-PhD2 жыл бұрын

    Excellent :) SHINE aka - polishing of a sturdy, turd!

  • @guytelfer1353
    @guytelfer13532 жыл бұрын

    Whatevers feeding the tumor

  • @dedetudor.

    @dedetudor.

    2 жыл бұрын

    They MADE the things that cause cancer and then sell the cure. The vicious cycle has rolled since Rockefeller took over everything medical. Look up Rockefeller Foundation and THEN look up who formed the American Cancer Society.

  • @eileenfb1948
    @eileenfb19482 жыл бұрын

    Shocking that intelligent people can put out this awful info - they know how bad it is. Shame on them.

  • @pointshealthcoaching8474
    @pointshealthcoaching84742 жыл бұрын

    I can't help but feel the ppl making the drugs / doing the research are not & don't want to be in touch with the humanity of this condition. They are too far removed...

  • @SymphonicEllen
    @SymphonicEllen2 жыл бұрын

    yup. They only care about money and status nowadays, and they're as bad as jr high girls as far as not critiquing their pals. Thanks so much. I like your curls :)

  • @vicguani2108
    @vicguani21082 жыл бұрын

    Hi doc no sound

  • @HerbaMachina

    @HerbaMachina

    2 жыл бұрын

    check your own hardware, because there is definitely sound

  • @thomashauer6804

    @thomashauer6804

    2 жыл бұрын

    Sound works

  • @jaredkelly5470

    @jaredkelly5470

    2 жыл бұрын

    Lol

  • @padmaprasad5496
    @padmaprasad54967 ай бұрын

    WHY SHOULD WE TAX PAYERS WHO LOVE OUR COUNTRY TAKE THIS SHIT FROM HER?

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