Question on Genetic Testing, how much is too much?

[Pops78]

This is wife. He has PC with mets to bones. Orch done July of 21. MO had genetic testing (DNA thru blood) done about 1 1/2 yrs ago, nothing significant according to a genetic counselor. Then a liquid biopsy was done with Foundation One on blood Oct. 22 because of new met to Sacrum. It showed cdk12 and suggested a different medicine, he's on Nubeqa. (RO doesn't put much faith in liquid biopsy's, neither does the cancer Neurosurgeon he saw to confirm it's not a Cordoma). No new med added. 1 wk of IMRT was done Nov. 22 with results on scans of Dec. 22 showing had grown slightly, all existing mets has remained stable. PSA has remained at <01 now for a little over a year, Prostate no longer enlarged. New scan 1/23 shows Sacrum met now stable. Biopsy to Sacrum done 1/23, it is a met from Prostate and tissue is being tested. MO now wants another genetic testing (blood DNA) I think, done with Tempus. How many genetic testings are normal? Anyone else had this many?

[Tall_Allen]

I don't have much confidence in genomic blood test unless there are lots of metastases. If they removed met tissue for histology/IHC, do they have enough tissue left over for genomics? But met genomics is a moving target (genomic breakdown is characteristic of cancer) - maybe wait until there are more metastases to target?

I compiled a list of CDK12 trials here:

healthunlocked.com/advanced...

[Seasid in reply to Tall_Allen]

Thank you.

[Pops78 in reply to Tall_Allen]

Thanks TA. In my limited knowledge, why test blood again when there's tissue being tested? Isn't tissue always more accurate than blood? Which is why they wanted a biopsy in the first place. And thanks for the info you sent on CDK12 trials. Hoping the tissue being tested contradicts the findings of CDK12 on liquid biopsy. As always, appreciate your knowledge and response.

[Tall_Allen in reply to Pops78]

The advantage of a blood genomic test is that it potentially includes all the metastases that slough off cancer cells. A biopsy only tells you about that one tumor.

[RMontana]

Here is the best mapping of genetic testing I have seen. I had Decipher done for my tumor but it was semi confined to the glad; your husband has MET so this is different. I think its important to get the right test at the right time to be able to select the best treatment at that moment...this disease offers a moving target for sure. See what you think after watching and determine if it makes sense to do anything else. I would want to know the genetic nature of the cell and if its super aggressive or not. Key is the doubling time; it its 6 months of less for PSA doubling that is a problem...at 15 monthts not so much...lots to digest. TNX

healthunlocked.com/active-s...

[Pops78 in reply to RMontana]

Thanks RMontana, yes, so many unknowns for this disease. At 80 years old, with Dementia, maybe early onset Alzheimers, it's really a rough road. Thanks for the info. Appreciate this site and all on it who are so knowledgeable and helpful.