What is this test?

[Tekton]

What is this test looking for? Electronic messaging system at U.W. sent a long test result. I meet with M.O. November 6. I know he's looking at what next treatment might be. I would like to know what this test is just so I know before appointment.

OncoPlex Result(NOTE)

1) POSITIVE for TMPRSS2-SRPK2 rearrangement and additional

alterations (see interpretation).

2) NEGATIVE for microsatellite instability.

3) Total mutation burden estimated at 2 mutation per Mb (low).

[Tall_Allen]

This was a genomic tumor tissue test. TMPRSS2-ERG rearrangement is a common mutation with advanced PC. There are some clinical trials aimed at it. Microsatellite instability, if high, is an indication for Keytruda.

[Tekton in reply to Tall_Allen]

Thank you Tall Allen,

it's interesting to be both on the sidelines and also right smack in the middle of it. I like learning what I can but some of this stuff is way over my head.

[johngwilk in reply to Tekton]

The interpretation in the Oncolpex report should include information about what treatment(s) your mutation may open up for you. It may be just one or two sentences buried in all the jargon.

Here are the relevant sentences from my Oncoplex report:

"Early preclinical data suggest that CDK12 mutations may sensitize cancer cells to platinum based therapy or PARP inhibitor therapy in some cancer types (Joshi 2014, Ekumi 2015). It is currently unknown if CDK12 mutations sensitize to platinum based therapy or PARP inhibitor therapy in prostate cancer, or whether these therapies would benefit this patient."

Later clinical studies showed a possible benefit from Keytruda.

Are you getting treatment at SCCA?

[Tekton in reply to johngwilk]

I called SCCA when I had my surgery. They felt Dr Hsieh at the UW was my best match. He is also a researcher at Fred Hutchinson.

And you?

[johngwilk in reply to Tekton]

My MO is Evan Yu at SCCA.

[Tekton in reply to johngwilk]

How aggressive is your cancer?

I had the feeling that they picked Dr Hsieh based on my numbers and Ductal features.

I have yet to meet anyone else who SCCA sent to the UW Medical Center.

[johngwilk in reply to Tekton]

Aggressive. Stage 4, PSA at dx was 10,009. Gleason 4+5. Widely disseminated skeletal mets.

[Tekton in reply to johngwilk]

Wow, nasty stuff. Sorry to see um. What's your treatment been?

[johngwilk in reply to Tekton]

Docetaxel + Lupron, Sipuleucel-T clinical trial, Zytiga (failed), cabazitaxel + Xtandi clinical trial (failed). Currently doing Lynparza (olaparib PARP inhibitor). Too early to tell on that. Next up: carboplatin platinum-based chemo, then Keytruda. Considering all that, my main concern is fatigue.

[Tekton in reply to johngwilk]

I am amazed at how many different drugs and combinations there are. Looks like you've been through the ringer. I wish you well. I'll try to follow your posts.

[Hidden in reply to johngwilk]

Whoa nelly!