Genetic testing

[Ssullivan19706]

Just curious how many people have had g-nome testing done. I feel I should have done this from the beginning to figure out what will work best. At this point it seems the chemo, casodex, Zytiga that have done nothing was a big waist of time and money. I am now on a targeted theropy called lymparza that took months to get as it is not approved for prostate cancer .

[noirhole]

How is that working?

[Ssullivan19706 in reply to noirhole]

I have had only been on two wks. I had blood work yesterday, all looked good except my PSA was 180 up from 130. But he said two wks is not enough time for the drug to start working

[Tall_Allen in reply to Ssullivan19706]

There is often a PSA surge when therapy begins. At this point, what would genomic testing tell you that could change treatment? It could tell you Zytiga won't work - but you already know that. It could tell you a PARP inhibitor (Lynparza) might work - but you are already trying it, so you will know very soon. The only other genetic test is for a defect called MSI-H/dMMR. You can be biopsied and tested for that specifically, which would qualify you for Keytruda.

[Ssullivan19706]

Because I have spent 2 plus years taking drugs that do not work while my cancer gets worse. Not to mention the cost. Why not find out up front what will work or may work.

[cfrees1]

I asked my oncologist the same question. It was kind of a complicated answer but basically he said that there was no point in getting the original prostate tumor tested because the cancer keeps mutating. So when there is an appropriate time later on in the disease progression, we would want to take cells from the most current met. He also said that they don't have enough information yet to make good use of the information. They don't know which treatments correspond to which defects yet. That will probably change in the future, but for now it doesn't help a great deal Also, I think that the genetic testing gives you a likelihood of a drug working or not, but even if it might not be likely to work, I would still want to try it on the off chance that I'm an outlier. In my opinion, and that is probably not worth much, the genetic testing thing doesn't do a great deal yet. I think the real hope in immunotherapy, as with that therapy, the T-cells can mutate right along with the cancer. That's where my hope is centered.

[AlanMeyer in reply to cfrees1]

cfrees1 wrote:

> They don't know which treatments correspond to which defects yet.

I think that comment summarizes the problem. There are a few drugs for which specific genetic tests for specific DNA mutations can rule out eligibility. In other words, if you don't have that mutation, the drug won't work. If you do, they might. But we're still in the dark about a lot of the drugs. For example, I haven't heard of any genetic test that will tell you if docetaxel, the main chemotherapy drug, will work or not.

Alan

[BigM62]

Foundation 1 is a blood test right?

[vandy69]

Good Friday Morning Ssullivan19706,

I have been in this battle for almost 6 years (please see bio for complete treatment history)

Over the course of treatment, I have had 4 Guardant360 liquid biopsies and 1 FoundationOne tissue biopsy.

Differences are in the names-- Guardant360 takes 2 vials of blood and FoundationOne requires a tissue sample. As your cancer mutates over time, FoundationOne is only useful with recent tissue sample. Guardant360 can be done anytime and reveals current genetic defects.

Similar to you, Dr. Snuffy Myers prescribed Lynparza after a Guardant360 indicated an ATM defect. Got about 9 months from Lynparza.

Reality of all these tests is that most identifiable genetic defects do not yet have any specific treatments.

Best wishes. Never Give In.

Mark, Atlanta

[Ssullivan19706]

Ty Mark. I am fighting hard. 47 and lots I still want to do and see.

[Hidden]

My husband is getting it done at Johns Hopkins this week. His father, uncle, brother and 2 first cousins all had/have prostate cancer.

[Hidden]

My husband’s biopsy slides are available from 15 years ago. It is always wise to check.

[Ssullivan19706]

I feel that is wise. Luckily mine turned out to not be ganetic. So good news for my kids

[kjscobel]

I am scheduled for Genetic testing in a few weeks. Looking forward to the results as my dad had PCa and my sister had breast cancer. Both passed away from those diseases.

[MelaniePaul]

Hi Ssullivan19706 and all.

This is a very interesting topic. I am often thinking about this and wondering how it could help my husband. Obviously his cancer is quite advanced with wide-spread bone and lymphnode mets and the liver mets. What could gene testing do for him?

Mel.

[Ssullivan19706]

I do not have that answer, but possibly find a mutation that a specific drug may help. Also for me it was important to find out if this was environmental or hereditary for my children. I was lucky and it was not hereditary so they do not have that cloud hanging over there heads