Pd-L1 high

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natelaugh
Posts: 95
Joined: Wed Apr 03, 2019 11:40 pm

Pd-L1 high

Postby natelaugh » Thu Nov 21, 2019 11:34 pm

Hi my dad got back his genome test.

What's this mean.
PD-L1 - High
RNA expression score 28

Thanks,
Nate
Caregiver to 80M
DX:CC,RC,desc
11/2018 rightPain
1/19/19 scopy,path
1/23 CTscan
2/19 surgery
2/26-2/28 NGTube
2/28-3/14 TPN bc ileus
3/2 2nd surgeryCloseOpenWound
3/4-3/28 woundVac
size: 6cm Adenocarcinoma
grade Poorly
Stage IIIC T3N2aMx
PositiveLymph:5of28
BaselineCEA:68
LVI:Y
PNI:N
Surgical margins:clear
MSI:MMR (MLH1, MSH2, MSH6, PMS2) Intact nuclear expression
Lynch status:N
Laparascopic, partial colectomy
CEA:3/28/19 2.8
Chemo:4/16/19-9/17/19 5FU,12cycles,every 14days,leucoverin,zofran,Dexamethasone

User avatar
GrouseMan
Posts: 827
Joined: Mon Aug 12, 2013 12:30 pm
Location: SE Michigan USA

Re: Pd-L1 high

Postby GrouseMan » Fri Nov 22, 2019 10:31 am

This means your dad might actually be a good candidate for a PD-L1 inhibitor. This is usually a bad sign as PD-L1 inhibits the immune system from attacking the cancer. Inhibition of this in people with high expression in combination with chemotherapy seems to have much better results. At least in lung cancer and with PD-1. No reason to assume the same can't happen with colon cancer. The following may be of interest to you.

This is about the typical clinical outcomes of patients with PD-L1 high expression.
https://www.ncbi.nlm.nih.gov/pubmed/30873025

This is about PD-1 and PDL1 inhibitors in general. Note Keytruda and Opdivo are PD-1 inhibitors lesser known are the PD-L1 inhibitors Tecentriq, and Bavencio. I believe the later Pfizer is conducting many clinical trials with in combinations with other chemotherapy
https://en.wikipedia.org/wiki/PD-1_and_PD-L1_inhibitors

And this last has to do with possible therapies:
https://www.ncbi.nlm.nih.gov/pubmed/31488176

Good Luck

GrouseMan
DW 53 dx Jun 2013
CT mets Liver Spleen lung. IVb CEA~110
Jul 2013 Sig Resct
8/13 FolFox,Avastin 12Tx mild sfx, Ongoing 5-FU Avastin every 3 wks.
CEA: good marker
7/7/14 CT Can't see the spleen Mets.
8/16/15 CEA Up, CT new abdominal mets. Iri, 5-FU, Avastin every 2 wks.
1/16 Iri, Erbitux and likely Avastin (Trial) CEA going >.
1/17 CEA up again dropped from Trial, Mets growth 4-6 mm in abdomen
5/2/17 Failed second trial, Hospitalized 15 days 5/11. Home Hospice 5/26, at peace 6/4/2017


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