Micro satellite instability test (MSI)

MSI - microsatellite Instability test is absolutely a great test for determining if immunotherapy is an option - something like 3-10% of gastric cancers are MSI-hi.

In addition, PD-L1 testing is also a good idea - but it should be a combined positive score where they take samples from both the tumour and surrounding tissue. A CPS of 10%+ may indicate an increased chance of a response to nivolumab or pembrolizumab.

SDH xx

Hi SDH,

First of all thank you so much for sharing your advices on this subject, so clear! I've been weeks trying to understand some of this concepts. My sister, 31 years old, has stomach cancer stage 4, signet ring cell cancer with met to the peritoneum. We just find out a month ago and everything g has been so fast. As you might tell, the prognosis isn't the best. Regardless that, she started FLOT4 and next Friday will be her 3rd session with almost non side effects, other than fatigue, a bit of alopecy and so. 

My deepest and simple question is about your dad's process and protocols. Which type of cancer he had? Was it diffuse or not? Had immunotherapy? Unfortunately my sister had her2 and pdl1 negative, also a low MSI. 

I know this are too much question but I'm a bit lost as her sister...she doesn't want to get us too involve with type of questions...she is dealing with so much!!

Kindly regards,

Fernanda

Ps: sorry about my English, I'm from Chile, Southamerica 

sorry for not responding sooner.

Dad's journey - all the details of his diagnosis and treatment to date is posted in my profile. He is PD-L1 positive, MSI stable but has not needed to have immunotherapy yet.

I hope your sister responds well to the FLOT x