What sample to send for somatic gene mutations test

[dvcarola2]

We have just seen our MO today and suggested not to send the prostate sample from my husband’s biopsy done in 2018. He prefers to have a latest sample from bone biopsy on the spine instead and send that sample to Foundation One. We have also seen an orthopedic surgeon referred by our MO who requested us to do an MRI first on T7-L5 before he does the bone biopsy. Hopefully he can extract something there.

My question is, is it better to send the bone biopsy sample rather than the prostatic sample from biopsy in 2018 to check for somatic mutation? Is it sufficient? Or should we send both sample for testing?

Also, what other tests can we do once we have the sample from bone biopsy that can help us with next treatment options? Aside from neuro endocrine tests? What else?

Not yet ready to give up.

TIA.

[GP24]

I would send the biopsy sample now to get a result quickly. Most people just send the existing biopsy samples.

If the bone biopsy is successfull you can send the bone biopsy sample later for another test. Sometimes your doctor cannot get enough tumor from the bone to allow for a successful test by Foundation.

[dvcarola2 in reply to GP24]

The test is expensive ($3k++) because it will be sent to the US and results will come in 2-3wks later. So, we cant afford sending separate samples for testing 😔

We will probably see if we have enough bone sample from bone biopsy and maybe decide from there.

[Magnus1964]

My research doctor said the bone biopsy would be better. That biopsy showed no cancer so he took a biopsy of from my prostate.

[dvcarola2 in reply to Magnus1964]

Yikes. So its possible that nothing will come out of the bone biopsy test 😭 If thats the case, i will ask if we need to pay 2x if we send both the prostate sample and bone sample for testing huhu.

[Tall_Allen]

Never send a prostate sample. As the cancer evolves and becomes metastatic, there are mutations that occur. Those mutations would not be present in the prostate sample. It is a waste of money.

There are very few genomic mutations that are currently actionable. Just BRCA, and MSI-hi/dMMR, and they are rare. There are more that are actionable based on cell histology and IHC. If you have limited metastatic material, I would get those done first.

[dvcarola2 in reply to Tall_Allen]

Thanks for the advise TA. Yes our MO said its better to send the latest bone biopsy sample for testing instead of the prostate sample from when my husband was diagnosed in 2018.

Im just hoping and praying that the doctor will be able to extract enough specimen for testing and that we will be able to get some actionable mutations. We will advise our MO to do IHC and neuroendocrine test as youve mentioned. Always grateful for your opnion! Thank you!