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Volvulus is a rare cause of intestinal obstruction and occurs mostly in sigmoid colon and cecum. It is more common in patients with Down syndrome. In this condition, it is even more challenging to diagnose the cause of intestinal obstruction through history and physical examination alone. Early diagnosis and intervention are critical in this condition to prevent serious side effects. Simultaneous volvulus is a sporadic case in the surgical entity. We report a very rare case of simultaneous volvulus of cecum and transverse colon, its management, and outcomes in a 20-year-old known case of Down syndrome.

Immuno-oncology is a young and growing field in cancer therapy. It stimulates immune system to target and attack the tumor or inhibiting the immune response. Recent findings in cancer immunotherapy has revealed that the immune system can control many cancers across various histologies, producing durable responses in a way which not seen with many small molecule drugs. Advances in understanding the role and molecular mechanisms of immunotherapy are revolutionizing clinical practice in cancer treatment. Immunotherapy is being intensively explored with the aim of improving primary response rates or prolonging overall survival. The purpose of this chapter is to review the different aspect of immunotherapy including blockade of immunological checkpoints, immuno-oncology and imaging biomarkers, immune response, therapeutic resistance and combination therapy, while several additional immuno-therapeutic strategies are also highlighted.

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