Genetic Testing question

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jep
Posts: 260
Joined: Sun Jun 11, 2017 7:45 pm
Location: New England, USA

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
Stage IV CC 5/16/17
Loc: recto-sig
Type: Adenocarcinoma
Size: 7.4 cm
Grade: G3
TNM: T3N2M1
LNs: 8/20
BL CEA: .9
LVI: present
Perineural invasion: present
LAR margins: clear (w/in microns)
Folfox (8/17-1/18)
Scope 6/18 - CLEAR! - 2 polyps
PET 10/17/18: 3 pos LNs
Irino + Vecti (11/18)
CEA: 1.7 (2/19)
Xel + rad (5/19)
Surgery: 8/21/19 (aborted)
P1 Trial 10/19 - 12/19
Bypass 12/6/19
Folfox + vecti 1/2/19 - 4/3/20
Kid Fail 5/1/20
Folfiri + Avastin 5/20 - 6/20
bypass 6/29/20
Stivarga 7/18/20 -
Home 9/10/20

NHMike
Posts: 2555
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.
6/17: ER rectal bleeding; Colonoscopy
7/17: 3B rectal. T3N1bM0. 5.2 4.5 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
7/17-9/17: Xeloda radiation
7/5: CEA 2.7; 8/16: 1.9; 11/30: 0.6; 12/20 1.4; 1/10 1.8; 1/31 2.2; 2/28 2.6; 4/10 2.8; 5/1 2.8; 5/29 3.2; 7/13 4.5; 8/9 2.8, 2/12 1.2
MSS, KRAS G12D
10/17: 2.7 2.2 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/17: LAR, Temp Ileostomy, Path Complete Response
CapeOx (8) 12/17-6/18
7/18: Reversal, Port Removal
2/19: Clean CT

jep
Posts: 260
Joined: Sun Jun 11, 2017 7:45 pm
Location: New England, USA

Re: Genetic Testing question

Postby jep » Tue Nov 07, 2017 5:36 pm

Great, thank you! I will check out that link as well.
Stage IV CC 5/16/17
Loc: recto-sig
Type: Adenocarcinoma
Size: 7.4 cm
Grade: G3
TNM: T3N2M1
LNs: 8/20
BL CEA: .9
LVI: present
Perineural invasion: present
LAR margins: clear (w/in microns)
Folfox (8/17-1/18)
Scope 6/18 - CLEAR! - 2 polyps
PET 10/17/18: 3 pos LNs
Irino + Vecti (11/18)
CEA: 1.7 (2/19)
Xel + rad (5/19)
Surgery: 8/21/19 (aborted)
P1 Trial 10/19 - 12/19
Bypass 12/6/19
Folfox + vecti 1/2/19 - 4/3/20
Kid Fail 5/1/20
Folfiri + Avastin 5/20 - 6/20
bypass 6/29/20
Stivarga 7/18/20 -
Home 9/10/20


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