Julia123 wrote:boxhill wrote:Julia123's signature indicated that she is MSS, not MSI.
Hi,
does this mean that a mutation test is not needed? I understand that this is not Lynch syndrome.
In my opinion, a mutation test is not really needed unless you are Stage IV. If you ever become Stage IV due to a recurrence, then a KRAS/NRAS/BRAF mutation panel is needed in order to determine which therapy regimens will be available to you. But you might want to have the test done now anyway, just to see what your status would be. Also, you may want to do a more extensive mutation test that will provide a
Tumor Mutation Burden (TMB) index, if these kinds of test panels are available in your area.
In the USA, the following therapy drugs are available for use by colorectal cancer patients. However, the ones in
bold face type below will require the KRAS/NRAS/BRAF mutation tests to see if you qualify for them. You would qualify for all the rest except the ones for 'MSI-H only'. You don't qualify for the 'MSI-H' drugs since your tumor is not MSI-H.
Drugs used in colorectal cancer, with ther FDA approval dates
1962 5-FU (Fluorouracil Injection) - no restrictions
1998 Xeloda (Capecitabine) - no restrictions
2000 Camptosar (Irinotecan Hydrochloride) - no restrictions
2004 Avastin (Bevacizumab) - mCRC 1st line+
2004 Eloxatin (Oxaliplatin) - no restrictions
2004 Erbitux (Cetuximab) - mCRC 1st line+, KRAS wild type only
2006 Vectibix (Panitumumab) - mCRC 1st line+, KRAS wild type only
2012 Keytruda (Pembrolizumab) - mCRC 1st line, MSI-H only
2012 Zaltrap (Ziv-Aflibercept) - mCRC 2nd line,
2012 Stivarga (Regorafenib) - no restrictions
2014 Cyramza (Ramucirumab) - mCRC 2nd line
2015 Lonsurf (Trifluridine and Tipiracil Hydrochloride) - no restrictions
2017 Opdivo (Nivolumab) - mCRC 1st line+, MSI-H only
2018 Yervoy (Ipilimumab) - mCRC 1st line+, MSI-H only
2019 Zirabev (Bevacizumab.alt) - mCRC 1st line+
2020 Braftovi (Encorafenib) - mCRC, BRAF V600E only