ctDNA results

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beach sunrise
Posts: 501
Joined: Thu Mar 05, 2020 7:14 pm

ctDNA results

Postby beach sunrise » Wed Jul 21, 2021 12:22 pm

Hi everyone, Signatera results for ctDNA are neg. So, my thinking is the node in upper right lobe is why CEA is still high and I want it out. Surgeon says NO its to small so we watch it. My reply was we take it out, watch it under microscope and see what happens to CEA level. On the hunt for a thoracic surgeon that will take out a 3-4mm node.
Studying the signatera test, this is what I get from it.
The first Signatera test was 2 parts.
First part was testing of biopsied tumor that revealed mutations, clinical trials for the mutations and listed disruptions found in the 440 more listed. How those play out is really anyones guess as their role is not fully understood.
Second part was how many circulating cells found per mL and charted. Here is summary of how it works.
Sensitivity is >95% at 0.3MTM/ml using KAPA HyperPrep library kit by Roche. Customized PCR assays are run to detect positivity or negativity of these variants within circulating plasma. ctDNA is considered postive when at least 2 individual-specific tumor variants are detected.
I have a few questions for my oncologist for sure as this is confusing.
8/19 RC CEA 82.6 T3N0M0
Neoadj 5FU/rad 6 wk
High dose IVC 1 1/2 wks before surgery. Continue still twice a week
Surg 1/20 APR - margins T4bN1a IIIC G2 MSI- 1/20 LN+ LVI+ PNI-
pre cea 24/post 5.9
FOLFOX
7 rds 6-10 CEA 11.4 No more
7/20 CEA 11.1, 8.8
8/20 CEA 7.8
9/20 CEA 8.8, 9, 8.6
10/20 CEA 8.1
11/20 CEA 8's
12/20 CEA 8's & 9's
ADAPT+++ TM drug
MHL1+
PMS2+
MSH2+
MSH6+
POLD1 , KRAS Q61H
Chem-sens test NCI "Test failed, neo adj CR worked. Not enough ca cells to test"

Hooandtrue93
Posts: 11
Joined: Tue May 11, 2021 10:28 pm

Re: ctDNA results

Postby Hooandtrue93 » Mon Jul 26, 2021 2:11 pm

MTM/ml is not cells. It's tumor DNA. From patient perspective it seems the same (at least for me at the beginning when I learned about it) but CTC = circulating tumor cells. You can have positive ctDNA but negative CTC.
28 year old, son of 62 year old mom
Stage 3B Duodenal Adenocarcinoma.
7/13 lymph nodes positive
02/22/2021: Whipple Surgery
04/08/2021: Port Surgery. CtDNA test sample taken (positive)
04/13/2021: Folfox-6 begins for 6 months

User avatar
beach sunrise
Posts: 501
Joined: Thu Mar 05, 2020 7:14 pm

Re: ctDNA results

Postby beach sunrise » Mon Jul 26, 2021 4:16 pm

Thank you for the correction. I get confused sometimes! It's so much to absorb so thanks again.
8/19 RC CEA 82.6 T3N0M0
Neoadj 5FU/rad 6 wk
High dose IVC 1 1/2 wks before surgery. Continue still twice a week
Surg 1/20 APR - margins T4bN1a IIIC G2 MSI- 1/20 LN+ LVI+ PNI-
pre cea 24/post 5.9
FOLFOX
7 rds 6-10 CEA 11.4 No more
7/20 CEA 11.1, 8.8
8/20 CEA 7.8
9/20 CEA 8.8, 9, 8.6
10/20 CEA 8.1
11/20 CEA 8's
12/20 CEA 8's & 9's
ADAPT+++ TM drug
MHL1+
PMS2+
MSH2+
MSH6+
POLD1 , KRAS Q61H
Chem-sens test NCI "Test failed, neo adj CR worked. Not enough ca cells to test"

Hooandtrue93
Posts: 11
Joined: Tue May 11, 2021 10:28 pm

Re: ctDNA results

Postby Hooandtrue93 » Mon Jul 26, 2021 5:03 pm

Please don't apologize. Far from the top of the list of things we need to worry about.
28 year old, son of 62 year old mom
Stage 3B Duodenal Adenocarcinoma.
7/13 lymph nodes positive
02/22/2021: Whipple Surgery
04/08/2021: Port Surgery. CtDNA test sample taken (positive)
04/13/2021: Folfox-6 begins for 6 months


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