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Purpose: Palliative care should be provided for terminal cancer patients, but the remaining question is how oncologists are providing palliative care. Herein, we evaluated the effectiveness of palliative care provided via video telemedicine. Methods: Terminal cancer patients receiving the best supportive care were enrolled and divided into two groups: telemedicine and no telemedicine. The primary endpoint was quality of life (QOL), which was evaluated using the difference in the Functional Assessment of Cancer Therapy–General (FACT-G) scores between baseline and at the 1-month follow-up. Secondary endpoints included depression measured using the Center for Epidemiologic Studies depression (CES-D) scale, overall survival (OS), and patient satisfaction. Results: Overall, 50 patients were included in this study,with 25 patients in each group. FACT-G decreased by 0.30 vs 5.90 points in the telemedicine and no telemedicine groups, respectively. Although there was no significant difference (P = 0.088), the telemedicine group tended to maintain better QOL. CES-D increased by 0.96 vs 3.52 points in the telemedicine and no telemedicine groups, respectively. Depressive tendency was lower in the telemedicine group; however, there was no significant difference (P = 0.27). Median survival time (MST) was 7.82 (3.30 – 14.59) vs 6.37 (2.33 – 11.04) months in the telemedicine and no telemedicine groups, respectively, and the HR was 0.67 (95%CI 0.33 – 1.34, P = 0.25). Conclusion: There was a trend toward improved QOL in patients receiving video telemedicine. It is desirable to further evaluate the effectiveness of palliative care with telemedicine and link it to clinical applications.

Background: Various malignancies exhibit high microsatellite instability (MSI-H) or mismatch repair deficiency (dMMR). The MSI-IVD kit, which can detect MSI status using a polymerase chain reaction (PCR)-based method, was approved as the first tumor-agnostic companion diagnostic for pembrolizumab in patients with MSI-H solid tumors in Japan. Recently, next-generation sequencing (NGS), which can also detect MSI-H/dMMR, has been made clinically available. However, the real-world concordance in MSI-H/dMMR between the PCR-based testing and NGS is yet to be thoroughly investigated.Methods: A retrospective study was conducted to evaluate the utility of MSI testing using PCR-based testing and NGS assay in patients eligible for both MSI testing and any NGS platform. Co-primary endpoints included positive and negative predictive values of MSI-H/dMMR.Results: Between December 2018 and June 2020, 40 patients underwent both PCR-based MSI testing and NGS assay for MSI. Two patients with gastric neuroendocrine carcinoma and ovarian cancer were confirmed to have MSI-H/dMMR in both examinations. Among the 38 patients diagnosed as microsatellite stable by PCR-based testing, 2 (5.2%) with pancreatic cancer were diagnosed as MSI-H after NGS analyses. NGS had positive and negative predictive values of 100% (2/2) and 94.7% (36/38), respectively, for MSI-H, while the concordance between NGS and PCR-based testing was 94.9% (38/40).Conclusion: Similar to PCR-based MSI testing, NGS can be useful for evaluating MSI/MMR status in clinical practice and could be an important alternative method for detecting MSI-H/dMMR in the future.