Question for Canadians re genomic testing

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Canada777
Posts: 57
Joined: Mon Mar 28, 2016 6:24 pm

Re: Question for Canadians re genomic testing

Postby Canada777 » Thu Jan 11, 2018 10:16 am

We are in Ontario. MSS/MSI testing was done before we had asked about it - so maybe standard for stage 4? A few months ago he was approached asking if he wanted to participate in a study that would take some of his already resected tumor sample and do a bunch of testing on it to get more details about it. They will provide us the results and then just want to monitor his medical records. Sounded like a win for us so we are just waiting to get the results back. I believe toronto and Hamilton was collecting participants for this study.
DH dx. Stage 4 Colon cancer with Peri mets Dec '15 @ age 29
12 Rounds FOLFOX Jan-June 2016
4 month chemo break. Still only Peri mets.
Successful HIPEC Oct. 2016. Diagnosis changed to appendix cancer.
Recurrence to pelvis. FOLFIRI Sept 2017-June 2018.
Radiation 5 days.

NHMike
Posts: 1725
Joined: Fri Jul 21, 2017 3:43 am

Re: Question for Canadians re genomic testing

Postby NHMike » Thu Jan 11, 2018 10:28 am

Canada777 wrote:We are in Ontario. MSS/MSI testing was done before we had asked about it - so maybe standard for stage 4? A few months ago he was approached asking if he wanted to participate in a study that would take some of his already resected tumor sample and do a bunch of testing on it to get more details about it. They will provide us the results and then just want to monitor his medical records. Sounded like a win for us so we are just waiting to get the results back. I believe toronto and Hamilton was collecting participants for this study.


I'm Stage 3B and MSS/MSI testing was done without me asking for it so it appears to be standard of care in the US so I think that it would also be standard of care for Stage 4. You might want to ask for more details on the testing. If it's NextGen testing, then definitely go for it as it should tell you what Gene Mutation or Gene Mutations he has and targeted treatments open up for certain kinds of gene mutations. Some drugs are contra-indicated for some Gene Mutations as well.

The previous method of tumor testing (and it's still used as it's cheaper) is to test one or two genes at a time. NextGen sequencing captures the whole Genome and tests for Gene Mutations known to be cancer-related and it can also find genetic differences that haven't been researched. You can see that my Gene Mutation is KRAS G12D in my signature below. I learned that as a result of Genomic Tumor Testing. But I'm pretty sure that insurance won't cover it. I asked my Oncologist to get the testing and he brushed me off. I know that Dana Farber Cancer Institute does it for Lung Cancer patients because there are targeted treatments for it. There are fewer targeted treatments for CRC but there are quite a few clinical trials for them and those might be much better options down the road.
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; 9/8: 1.8; 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
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

User avatar
CRguy
Posts: 9620
Joined: Sun Feb 10, 2008 6:00 pm

Re: Question for Canadians re genomic testing

Postby CRguy » Thu Jan 11, 2018 12:51 pm

Canada777 wrote:We are in Ontario. MSS/MSI testing was done before we had asked about it - so maybe standard for stage 4? A few months ago he was approached asking if he wanted to participate in a study that would take some of his already resected tumor sample and do a bunch of testing on it to get more details about it. They will provide us the results and then just want to monitor his medical records. Sounded like a win for us so we are just waiting to get the results back. I believe toronto and Hamilton was collecting participants for this study.

Would you be able to provide more exact details of this ????
If we can identify the exact centers / process / trial / contacts etc., then we would let other Canucks know about it as well
and they could push for in their own areas !!! .. or at least educate their own Docs

Cheers
CRguy
Caregiver x 3
Stage IV A rectal cancer/lung met
11 Year survivor
my life is an ongoing totally randomized UNcontrolled experiment with N=1 !
Review of my Journey so far

Canada777
Posts: 57
Joined: Mon Mar 28, 2016 6:24 pm

Re: Question for Canadians re genomic testing

Postby Canada777 » Thu Jan 11, 2018 3:34 pm

We've lost the copy of the consent paperwork....but i'm pretty sure this is the study info:

https://clinicaltrials.gov/show/NCT0290 ... ctlocation
DH dx. Stage 4 Colon cancer with Peri mets Dec '15 @ age 29
12 Rounds FOLFOX Jan-June 2016
4 month chemo break. Still only Peri mets.
Successful HIPEC Oct. 2016. Diagnosis changed to appendix cancer.
Recurrence to pelvis. FOLFIRI Sept 2017-June 2018.
Radiation 5 days.

NeVadasMitis
Posts: 20
Joined: Thu Feb 02, 2017 3:34 pm

Re: Question for Canadians re genomic testing

Postby NeVadasMitis » Fri Jan 12, 2018 2:14 pm

Thank you so much for sharing this! Our hospital is actually one of the locations listed!
DD dx Dec.2012, age 57, Stage I CRC
2013/01 complicated resection
2016 summer/fall CEA slowing rising...(2.1, 2.8, 3.1)
2016/12 scan shows "something" on RL of liver; fna biopsy ordered
2017/01 confirmed 1 met to liver (1.5x2 cm); Stage IVa; cea 3.1
2017/02 5mm node on lung
2017/03 liver resection
2017/05 wedge resection of lung node
2017/09 CEA rising....5.6, 8.9...
2017/12 pet confirms cancer is back in hepatic lymph node

NHMike
Posts: 1725
Joined: Fri Jul 21, 2017 3:43 am

Re: Question for Canadians re genomic testing

Postby NHMike » Fri Jan 12, 2018 2:14 pm

Interesting study. It appears that they want to see whether or not doing the testing is overall beneficial for patients with Stage 4 (of course it is).
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; 9/8: 1.8; 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
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


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