PIK3CA mutation

[Easey]

Hi to my fellow learned mates,

After having my biopsied liver tissue analysed , there appears to be a few gene mutations which hopefully have target potential.

I'm having a bit of a an issue with accessing the report but I do remember the doctor mentioning PIK3CA mutations as well AVR7 . There is the BRCA 2 as well however the doctor mentioned it is possible it has switched back and to what I can gather that is not ideal as it may no longer respond to parp.

There is hope that with the PIK3CA mutation I may have access to a breast cancer drug on compassionate grounds..

I've had docetaxel (fail) Cabazitaxel (fail) carboplatin (fail) and the cancer no longer requires testosterone as a metabolite.

I'm in deep shit and hoping there is still a get out of jail card I can use. The strange thing is that I have liver, lung and rib metastasis which seem to be growing out of control but I still feel great and I want to feel great for a while longer.

Love to here your feedback , suggestions please.

John

[tango65]

Some info about PIK3CA mutation:

medlineplus.gov/genetics/ge...

Alpelisib, a PIK3 inhibitor has been approved by the FDA for breast cancer.

fda.gov/news-events/press-a...

You could consider a clinical trial with Lu 177 PSMA, if the cancer is expressing enough PSMA.

clinicaltrials.gov/ct2/resu...

If you did not have treatment with Olaparib or Rucaparib you qualify for these drugs with a cancer that is BRCA positive. You also qualify for treatment with Provenge and/or Xofigo .

[Easey in reply to tango65]

I've been on a trial with Rucaparib and pretty sure from last pet/ct I'm not psma avid.

[tango65 in reply to Easey]

What kind of PET/CT did you have? PSMA PET/CT and FDG PET/CT could indicate if your cancer could respond to LU 177 PSMA therapy.

[Easey in reply to tango65]

PSMA pet/ct which I will have to confirm, showed the liver lesions clearly but not as much with the lungs. I will be asking about a trial in Sydney with a Knox pharma drug in combination with lutetium but I believe my psma expression may rule me out

[Tall_Allen]

I hope you get the drug. Which one is it?

[Easey in reply to Tall_Allen]

Hi TA , and thanks hoping for a change of luck !

I believe it's Piqray® (alpelisib)

I did send a message to the doc about a Roche drug Ipatasirtib used in combination therapy which has been used in breast cancer trials targeting the PIC3CA. , in case alpelisib is unavailable.

The doctor wants to see me this Friday to discuss a " novel treatment" - so I will let you know what that entail.

[GP24 in reply to Easey]

Here is an overview of the side effects of Alpelisib:

hcp.novartis.com/products/p...

[Easey in reply to GP24]

Thanks GP + All fairly tolerable I would think

[scarlino]

Curious but you did not mention if other tissue was biopsied. Are there different mutations in let’s say a lymph node or other tumor tissue?

[Easey]

I've had previous liver tissue biopsied and this year have had lung and liver tissue biopsied. There is no lymph node involvement and I'm pretty certain it's still garden variety PC and not endocrine.

[j-o-h-n]

Keytruda for the lungs...... works for me..... Best wishes....

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 10/15/2020 6:24 PM DST

[Easey]

Thanks J-O-H-N

Had Opdivo a similar drug when on trial a while back, may need to revisit with a Keytruda cocktail 🍹