Genetic Testing question

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jep
Posts: 56
Joined: Sun Jun 11, 2017 7:45 pm

Genetic Testing question

Postby jep » Tue Nov 07, 2017 4:56 pm

Hello everyone. So my husband's tumor was tested for BRAF, NRAS, and KRAS, and all were negative. I feel that this is positive not only for my kids, but also in terms of my husband's response to treatment. He's considered stage 4 because of 1 rogue lymph node that was away from the primary tumor site. We're super optimistic, but trying not to be naive about our circumstances. Can you give me your thougths regarding the results of the genetic testing, and also let me know if there are other tests that should have been done (or that we should request)?

I remember his doctor at MSK (our first opinion) talking about the results of a "mix-match" test (?), which were also negative.

Thank you everyone!
jep
Husband DX Stage IV CC on May 16, 2017
47 years old
Tumor Location: recto-sigmoid
Tumor type: Adenocarcinoma
Tumor size: 7.4 cm
Tumor grade: G3
TNM code: T3N2M1
Positive lymph nodes: 8 out of 20
Baseline CEA value: .9
LVI: present
Perineural invasion: present
Surgical margins: clear (w/in microns)
Primary surgery type: LAR
Folfox (August 2017-January 2018)

NHMike
Posts: 1102
Joined: Fri Jul 21, 2017 3:43 am

Re: Genetic Testing question

Postby NHMike » Tue Nov 07, 2017 5:12 pm

According to the MGH page on CRC:

AKT1, APC, CTNNB1, EGFR, FGFR, PIK3CA, PTEN, SMO, TP53, TRK.

They're described at https://targetedcancercare.massgeneral. ... ancer.aspx

Next Gen Sequencing should be able to do all of these in one shot. Previous sequencing was one or two tests at a time.
6/23/17: ER rectal bleeding; Colonoscopy
7/13: Stage 3B rectal. T3N1bM0. 5.2 x 4.5 x 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
7/31-9/8: Xeloda 3,400 mg/day+radiation
7/5: CEA 2.7; 8/16: 1.9; 9/8: 1.8; 11/30: 0.6; 12/20 1.4
MSS, KRAS G12D
10/6: 2.7 x 2.2 x 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/30: LAR, Temp Ileostomy, Path Complete Response
12/20: Started CapeOx

jep
Posts: 56
Joined: Sun Jun 11, 2017 7:45 pm

Re: Genetic Testing question

Postby jep » Tue Nov 07, 2017 5:36 pm

Great, thank you! I will check out that link as well.
Husband DX Stage IV CC on May 16, 2017
47 years old
Tumor Location: recto-sigmoid
Tumor type: Adenocarcinoma
Tumor size: 7.4 cm
Tumor grade: G3
TNM code: T3N2M1
Positive lymph nodes: 8 out of 20
Baseline CEA value: .9
LVI: present
Perineural invasion: present
Surgical margins: clear (w/in microns)
Primary surgery type: LAR
Folfox (August 2017-January 2018)


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