Standard genetic testing panel for PCa?

[Sea5]

Hi all, today we got the disappointing news that the docetaxel did not work for my dad (who turns 87 next month). He had one full dose, and didn’t weather it well at all. He got a port, which was never functional due to a fibrin sheath. He received 2 reduced doses of Docetaxel, and got through it, but not without difficulty....alas, all for naught.

His local doc (a general oncologist) mentioned testing for MSI. I touched base with our MO and he is supportive of doing the genetic testing, in hopes of it opening a door for other treatment options. My question is, is there a standard panel for prostate cancer? Is it odd that the doc mentioned only testing for one genetic component? Are there others that we should request be included, as long as we’re going to be testing?

Thanks for any info and advice.

[Tall_Allen]

MSI-hi is an indication for Keytruda. It is rare among prostate cancer patients. The other actionable genomic traits are PD-L1, tumor mutational burden, and BRCA mutations - all rare in prostate cancer. Unfortunately, there are a lot of common mutations (e.g., PTEN loss, p53, MYC amplification, etc.) for which there are no known therapies, but some in clinical trials. There are scores of tumor mutations. There is a much shorter list of germline mutations.

[Sea5 in reply to Tall_Allen]

Thanks for this info! Since the doc only mentioned Keytruda, it seems reasonable to me to inquire about including PD-L1, tumor mutational burden, and BRCA (I’m one of my father’s two daughters).

[Tall_Allen in reply to Sea5]

I was talking about genetic testing of tumor tissue, not germline testing.

[Sea5 in reply to Tall_Allen]

Thanks...don’t mean to not be clear on understanding things; this is a whole new world of info for me.

[j-o-h-n in reply to Sea5]

Apples and Oranges but just FYI I've been taking Keytruda for my lung melanoma and so far it's working. Give your Dad my regards....

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 11/17/2019 6:11 PM EST

[Sea5 in reply to j-o-h-n]

Good to hear! I’m so glad it is working for you! Have you had any problematic side effects? I haven’t researched Keytruda at all yet....trying to let the horse get in front of the cart, I guess!

[j-o-h-n in reply to Sea5]

Absolutely no side effects.... except every treatment is $30K.... (but I'm fully covered, thank goodness)... Hope it works for your Dad... Get him a buggy whip for the horse.....

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 11/17/2019 9:55 PM EST

[Sea5 in reply to j-o-h-n]

Oh, that’s terrific! Thanks ever so much for the info and the good wishes....and of course also for the good humor!

[Sea5]

Thank you...will do!