CDK 12

[Fight11]

My husband went to the Oncologist this morning. They did genetic testing on him and he got his results he has the CDK 12 gene. Can anyone please help me with this? I have no idea!!! The doctor said he has never heard of that gene. Pray there is some treatment. I looked it up however that’s all jibber jabber to me I don’t understand at all

[tango65]

It is a gene involved in the repair of DNA.

ghr.nlm.nih.gov/gene/CDK12

It could respond to treatment with Olaparib or Rucaparib, but the response is much less than the one seen with BRCA mutations. The response to these drugs could be ineffective in many patients.

Some patients could respond to Keytruda or Opdivo.

[Fight11 in reply to tango65]

It’s that a very worrisome gene to have? Is there any treatment

[tango65 in reply to Fight11]

I believe Olaparib and Rucaparib or Keytruda are not approved for CDK12 mutation. You need to discuss the situation with the MO and see if there is a clinical trial.

ncbi.nlm.nih.gov/pmc/articl...

[Tall_Allen]

Like most gene mutations, there are no treatments especially for it. PARP inhibitors do not work. A certain kind of immunotherapy (like Tecentriq or Keytruda) may have some effect:

ncbi.nlm.nih.gov/pmc/articl...

There is a planned clinical trial for a combination of two medicines: Verzenio (abemaciclib) and Tecentriq (atezolizumab). Verzenio is approved for breast cancer, but not for prostate cancer. Tecentriq is approved for a variety of cancers, but not for prostate cancer. I don't know if his oncologist can obtain these drugs for him and what the cost would be. But it may be worth a discussion to see if he can duplicate the protocol in this clinical trial:

clinicaltrials.gov/ct2/show...

There is also this clinical trial of Keytruda (pembrolizumab) at the VA. Keytruda is only approved for a certain mutation that he doesn't have, but it is available off-label:

clinicaltrials.gov/ct2/show...

[p3d1]

CDK12 may be sensitive to immunotherapy treatment.

I could send you a PDF of an article that would give you some more information but I do not know how to do it!!

If anyone knows how to attach a PDF to a reply please assist.

[Fight11 in reply to p3d1]

Is this gene more dangerous or rare than other I should say!!!

[p3d1 in reply to Fight11]

I cannot say if it is a more dangerous mutation. Most of the actionable genes are rare, Probably less than 10% for some and only 1 or 2% for most. What most people are looking for is a gene that is, or may become a biomarker for certain treatments.

When we have those possible biomarker genes it opens up possibilities for precision trials. Trials in the past would be open to all comers. Because of that the success rates would be limited.

Newer trials are attempting to be more precise and are selecting cohorts of patients whom they believe will lead to higher success rates. This selection also tries to keep patients who they believe will not have success to Avoid side effects needlessly.

You have a CDK12 gene mutation. This may lead to opportunities for trials that will help you.

I hope that it is good news in your case.

[CalBear74 in reply to p3d1]

We need to know more about your email and browser to help you.

[p3d1 in reply to CalBear74]

Hi CalBear74,

My email is Outlook and Browser is Chrome running on a Windows 10 enterprise Laptop.

[CalBear74 in reply to p3d1]

Sorry, I cannot be of help. I have no experience with either application. Surely there is someone in the community who can help you. Folks step forward. (We Apple people are inbred.)

[j-o-h-n in reply to p3d1]

Off line get her email addy and send the pdf file in an email as an attachment(s).

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 09/25/2020 7:44 PM DST

[Fight11 in reply to j-o-h-n]

??

[j-o-h-n in reply to Fight11]

post meant for p3d1 not you......... see my addresee

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 09/25/2020 8:00 PM DST

[Fight11]

So this is a bad gene mutation?

[tango65]

There are some clinical trials for CDK12 mutation:

clinicaltrials.gov/ct2/resu...

Discuss with your MO if he could qualify for any of them. One of the trials is with Keytruda which could have some response.

clinicaltrials.gov/ct2/show...

Other is with Olaparib and durvalumab which is "similar" to Keytruda

clinicaltrials.gov/ct2/show...

[StayPositive1]

I believe 6% of us have this CDK12 mutation. I’m one of them, but I’m not castration resistant. I would think there is another doctor in MA that is familiar with this. Best of luck to you.

[Fight11]

May I ask what you have been told about the gene?

[StayPositive1 in reply to Fight11]

My basic understanding is that CDK12 guys generally don’t have the same levels of response to the traditional treatments. I don’t want to complicate your situation, but you might consider looking into a doctor with more experience. I found the below thread where someone was looking for an MO in Boston. Hang in there Manohar11

healthunlocked.com/advanced...

[dadzone43]

ascopubs.org/doi/abs/10.120...