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KRAS and other findings help

Posted: Wed Oct 30, 2019 3:29 pm
by SilverWedding
Just more concern?

Could someone explain implications or anything on:

KRAS RESULTS
Heterozygous mutation in KRAS codon 13 detected. This mutation in Exon 2 may respond to monoclonal antibody therapy.

BRAF RESULTS
Not detected

NRAS RESULTS
Not detected

MSI RESULTS
MSS/MSI-L (Instability observed in 0 of 5 informative markers)

MMR PROTEIN, IHC ONLY, TUMOR RESULTS
IHC: Normal expression of MLH-1, MSH-2, MSH-6, & PMS-2

Re: KRAS and other findings help

Posted: Wed Oct 30, 2019 3:41 pm
by Claudine
In summary, your husband is KRAS mutated (codon 13), BRAF wild, WSS (microsatellite stable). This means that he is not a good candidate for immunotherapy (which works better if you're MSI), and because of the KRAS mutation the anti-EGFRdrugs (cetuximab or panitumumab) will not work. As you can see in my signature, that's similar to my husband, except that his KRAS mutation in on codon 12. These results should help his oncologist orient your treatment.

Re: KRAS and other findings help

Posted: Wed Oct 30, 2019 3:56 pm
by Claudine
Oh, I'm reading your post again and despite being MSS, it looks like the KRAS mutation your husband has may make him a candidate for immunotherapy! Yay, one more possible treatment! So maybe I read this all wrong. Others, please chime in!

Re: KRAS and other findings help

Posted: Wed Oct 30, 2019 3:59 pm
by SilverWedding
Thank you, Claudine. What was I hoping to get regarding KRAS and BRAD and MSI? Is this very bad news?

Re: KRAS and other findings help

Posted: Wed Oct 30, 2019 4:16 pm
by Claudine
When we got the results of my husband's analysis, I jumped on Google hoping I'd read something like, "Stage 4 CRC is really really bad UNLESS you have a KRAS G12A mutation, in which case there's a miracle drug that will heal you!". Well maybe not exactly like that, but you get my drift.
As you can imagine, that's not the case. I think studies that state that one mutation is "worse" than another can be misleading; they're often based on small sample sizes, and older data. Cancer in general is pretty bad news, but as you can see from survivors who post here, it's not the death sentence that it used to be!

Re: KRAS and other findings help

Posted: Wed Oct 30, 2019 7:10 pm
by zephyr
I'm not a medical professional, just another patient. From what I understand, KRAS is a fairly common mutation that can make the cancer difficult to treat. A large percentage of patients (myself included) with colon cancer have the KRAS mutation. I've read estimates as low as 30% - 40% to as high as "over half". With so many people having the mutation, there's a lot of KRAS treatment research on-going. If you search on PubMed for "KRAS Vitamin C", there are interesting studies about high-dose Vitamin C IVs selectively targeting KRAS and other mutations. You may be able to find other treatment suggestions but I've only focused on high dose Vitamin C for now because it seems to be working for me.

Regarding MSS, it limits your treatment options, at least for now. From what I understand, at this time immunotherapy is not an option for patients with MSS. I don't understand enough to try to explain why. There is also a lot of research on-going in that regard, including trials. I haven't yet looked into any but there's an MSS Trial Finder here:
https://fightcolorectalcancer.org/fight/library/dr-toms-late-stage-mss-crc-trial-finder/

I hope this gets you going in the right direction.

Re: KRAS and other findings help

Posted: Wed Oct 30, 2019 10:03 pm
by natelaugh

Re: KRAS and other findings help

Posted: Thu Oct 31, 2019 12:12 pm
by NHMike
See http://targetedcancercare.massgeneral.o ... /KRAS.aspx for a technical description of KRAS mutations. KRAS mutations constitute 30% of Colorectal Cancers. KRAS mutations have been difficult to treat with immunotherapy as the mutation is inside the cell and there has been some, but not a lot, of progress in identifying cell surface markers for the mutations. There has been notable progress at the National Cancer Institute for mutations G12D and G12V but there are a lot of KRAS mutations so there is a lot of work to be done. The NCI solutions also require particular patient alleles.

Image

Re: KRAS and other findings help

Posted: Tue Nov 05, 2019 2:11 pm
by Cured
Team Colon Club, Thanks for the insight. I have asked my Onc to catch me up on the current descriptors. 11 years ago when I was diagnosed, it was adenocarcinoma and not much else. I get that these genetic/molecular markers allow for more precise treatments and testing of new treatments. I hope to learn what each means. Then I need to update my signature here, too. So far I understand that my markers say that Keytruda and such immunotherapy won’t work for me. Thank God that the traditional treatments have worked.

We know that our bodies were created to fight off cancers. I need to get more exercise, as I am stronger now. Hopefully staying in Ketosis will help to starve the cancer too.