newly diagnosed

[Green Tea]

Hello Coral,

Just for the record, here are some off-hand comments of mine that might eventually help your husband at a later point in time to put his genomic biomarker test results in perspective.

He can bookmark this post right now and read it sometime much later towards the end of his CAPOX regimen, since these comments of mine primarily concern the role of genomic biomarkers in the planning for possible recurrences only during the 5-year CAPOX follow-up period, and are not really so relevant at this point in time.

In your signature, you mentioned "MSS" as well as "KRAS - No mutations found". These two results are especially important, and were apparently derived exclusively from testing the DNA of the primary tumor or from the primary tumor's local metastases, and this type of test is usually called a "genomic" test -- at least on this forum

This kind of test is not to be confused with the type of test called a "genetic" test, which is a test of the DNA in cells in all other normal parts of the body, like the blood, urine, saliva, or any non-cancerous fluid or tissue in the body.

"Genetic" tests are usually done to reveal hereditary mutations in DNA, such as found in Lynch Syndrome (HNPPC) or Familial Adenomatous Polyposis (FAP)

On the other hand "Genomic" tests, in the CRC context, are primarily concerned with cancerous tissues and are done in an attempt to understand how and why the cancer developed, and how it could spread or metastasize, and how the tumor's metastases (if any) could be targeted for elimination.

In summary, then, your husband's abbreviated genomic biomarker is Type #1 in the list that I have prepared below. Type #1 is by far the most prevalent biomarker profile on the list, appearing in roughly half of all CRC cases. (Note: The percentages listed below are my very, very own approximate estimates of prevalence that serve mainly to put the four main biomarker types in a rank order sequence.}

Type #1: (MSS) & KRAS(wildtype) ~51% around half of all CRC cases
Type #2: (MSS) & KRAS(mutant) ~34%
Type #3: (MSI-H) & KRAS(wildtype) ~09%
Type #4: (MSI-H) & KRAS(mutant) ~06%

Genomic biomarkers are primarily useful when making treatment decisions if and when a recurrence occurs. They help identify which 1st-line mCRC treatments are likely to work and which ones are likely to be of little use.

In your husband's case, his genomic profile suggests that, if he were to have a recurrence after finishing the CAPOX regimen, he could benefit from a regimen like Erbitux (cetuximab), but probably not from any of the immunotherapy regimens. For MSS tumors, immunotherapies are not particularly useful since immunotherapies depend mainly on targeting those pathways that exist in the MSI-H environment.

Note: I'm providing an extremely simplified summary of a very complex subject here in an attempt to provide a quick bird's-eye view. Admittedly. this summary is incomplete and perhaps erroneous in various aspects, but I hope it provides at least some sort of helpful overview.

For a better, more complete summary of the biomarker area, I would suggest reading the following web page on the FightCRC website:

COLORECTAL CANCER BIOMARKERS: A Game-Changer for Treatment Options

https://fightcolorectalcancer.org/facing-colorectal-cancer/colorectal-cancer-biomarkers/

Also:
https://www.ed.ac.uk/institute-genetics-cancer

[Green Tea]

..Starting 4 cycles of CAPOX chemo on 09/09/24...

Hello Coral.

Please let your husband know that we will be thinking of him and wishing him well as he begins his CAPOX regimen.

Take care ...

[Green Tea]

..Starting 4 cycles of CAPOX chemo on 09/09/24...

Hello Coral.

Please let your husband know that we will be thinking of him and wishing him well as he begins his CAPOX regimen.

Take care ...

Hello Coral

It looks like by now your husband has finished his first cycle of 2-weeks of capecitabine therapy. Hopefully he made it through these first two weeks without major problems.

Please let us know how he is doing now.

Thank you.