Fewer mutations in liver met - a good sign?

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mpbser
Posts: 927
Joined: Wed Apr 19, 2017 11:52 am

Fewer mutations in liver met - a good sign?

Postby mpbser » Wed Oct 09, 2019 6:20 am

My husband and I went to Weill-Cornell last week and went over the genomic testing (“Oncomine”) results from the metastasis that was removed in March. I found it very interesting that the “met” that was tested had only two (tp53 and apc) of the three mutations that the primary tumor (tp53, apc, and mtor in the original colon tumor) had. Also interestingly, the two (tp53 and apc) were exactly the same variants as were in the primary. From what I understand, this is a good sign. Usually, if a cancer is getting wily and evolving to evade the body’s defenses and chemo, there will be new/different mutations.

Also, the one that was not detected, mTOR, is positively correlated with type 2 diabetes. My husband has been taking supplements that target his blood sugar and working on his diet (not great but far better than when he was ~400 pounds before I ever met him). I wonder if that is making the difference.

We are awaiting results from a liquid biopsy and whole exome sequencing. (I started another threat about EXaCT1, the whole exome sequencing test.) It would be very interesting to get a whole exome sequencing test on his first and second colon primary tumors to compare to the liver met. There's also his first liver met preserved and untested.
Wife 4/17 Dx age 45
5/17 LAR
Adenocarcinoma
low grade
1st primary T3 N2b M1a
Stage IVA
8/17 Sub-total colectomy
2nd primary 5.5 cm T1 N0
9 of 96 nodes
CEA: < 2.9
MSS
Lynch no; KRAS wild
Immunohistochemsistry Normal
Fall 2017 FOLFOX shrank the 1 met in liver
1/18 Liver left hepatectomy seg 4
5/18 CT clear
12/18 MRI 1 liver met
3/7/19 Resection & HAI
4/1/19 Folfiri & FUDR
5/13/19 HAI pump catheter dislodge, nearly bled to death
6-7 '19 5FU 4 cycles
NED

Gravelyguy
Posts: 229
Joined: Thu Jul 05, 2018 6:03 pm

Re: Fewer mutations in liver met - a good sign?

Postby Gravelyguy » Wed Oct 09, 2019 9:22 pm

It is amazing how much we can be learned about the tumors. That has to be good news for figuring out how to stop this nasty disease. I have nothing to add other than hope your husband gets to ned and stays there!

Dave
6/17 dx mRC t3n1m1 very low rectal tumor 2 liver Mets 1.3 cm and .9 cm

6/17 begin 4 rounds Folfox w/Vectibix
9/17 short course radiation
10/17 rectal and liver resection LAR with coloanal anastomosis (no rectum left)
11/17-3/18 8 rounds Folfox
6/18 still NED!! Takedown
8/28/18 still NED! CEA .8 new low for me
10/18/18 colonoscopy clear
12/12/18 clear scans, CEA .9 still NED!
6/11/19 clear scans CEA 1.0

mpbser
Posts: 927
Joined: Wed Apr 19, 2017 11:52 am

Re: Fewer mutations in liver met - a good sign?

Postby mpbser » Thu Oct 10, 2019 4:38 pm

Thanks, gravelguy. Actually, he is NED. Has been since March surgery (liver #2). I really hope that the one pesky met that popped up after his first liver surgery (Jan 2018 surgery, found met Dec 2018) was just a micromet that was missed. His Mass General docs did not have him do mop-up chemo which I think was a bad decision. This time around, now at MSK, he did HAI chemo and six rounds of systemic chemo after surgery.

Sure will learn a lot with the liquid biopsy. Praying it finds nothing!!!
Wife 4/17 Dx age 45
5/17 LAR
Adenocarcinoma
low grade
1st primary T3 N2b M1a
Stage IVA
8/17 Sub-total colectomy
2nd primary 5.5 cm T1 N0
9 of 96 nodes
CEA: < 2.9
MSS
Lynch no; KRAS wild
Immunohistochemsistry Normal
Fall 2017 FOLFOX shrank the 1 met in liver
1/18 Liver left hepatectomy seg 4
5/18 CT clear
12/18 MRI 1 liver met
3/7/19 Resection & HAI
4/1/19 Folfiri & FUDR
5/13/19 HAI pump catheter dislodge, nearly bled to death
6-7 '19 5FU 4 cycles
NED


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