Genetic test

[APK3]

Got a copy of my Tempest test. My MO says "No actionable results" meaning plan of action doesn't change (Triplet Therapy). He also stated I had nothing to pass on to my son as far as hereditary gene problems. I have no clue what any of it means.

DNA mismatch expression (normal)

Homologous recombination (not detected) score of 4.

Pd-L1 Negative

Tumor proportion score TPS <1%

Combined Positive score <1%

PTEN copy number loss. Does this make me resistant to therapy?

(no potential germ line variants were found) ?

Tumor Mutational burden 0.5m/MB 2nd percentile

Microsatellite Instability (stable)

Blood tumor Mutational burden (3.8m/MB)

Microsatellite instability status MSI-High not detected.

I'd appreciate any education anyone could pass along to me about any of this . Thanks

[MoonRocket]

PTEN Loss is common in prostate cancer. Probably wouldn't focus on that now...focus on the triplet therapy. Your tumor mutation is low which is good. The rest of the results are typical for the majority of PCA patients. Good Luck with your treatments.

[APK3 in reply to MoonRocket]

Thank you MoonRocket..It is appreciated.

[Ahk1 in reply to MoonRocket]

Can you please help me understand this:

Summary: no mutations, no copy number alterations, 2 structural variants detected.

MSI Status: MICROSATELLITE STABLE (MSS). The MSIsensor score is 2.73.

TUMOR MUTATION BURDEN: Tumor mutation burden (TMB) for this sample is 0 mutations per Megabase.

POSITIVE FOR THE FOLLOWING SOMATIC ALTERATIONS:

1. PTEN (NM_000314) rearrangement: c.80-782_c.85del (Note: 1)

2. TMPRSS2 (NM_001135099) - ERG (NM_182918) fusion: c.55+2848:TMPRSS2_c.18+4607:ERGdel (Note: 2)

Notes:

1. The PTEN rearrangement is an intragenic deletion of exon 2. One of the breakpoints is within exon 2. 2. The TMPRSS2 - ERG fusion involves TMPRSS2 exon 1 and ERG exons 2 - 10.

MEAN OVERALL COVERAGE (SEQUENCING DEPTH) IN THIS SAMPLE: 356X

The following exons with OncoKB levels of actionability associations showed coverage of less than 100X. A false negative result cannot be excluded in these regions, especially in samples with low neoplastic cell content.

CHEK2 (NM_007194) exon14 (488-514), exon13 (459-487), exon12 (420-459) PIK3CA (NM_006218) exon12 (583-637), exon14 (672-729)

[MoonRocket in reply to Ahk1]

PTEN and TMPRSS2 are some of the most common mutations found in genetic testing in prostate cancer. The are not actionable ie no treatment that target these mutations as of today.While genetic testing should be done, the probably of finding an actionable mutation is still relatively low.

What genetic testing company performed the testing? What was the source; tumor or blood)?

[Ahk1 in reply to MoonRocket]

Thank you for replying. It was a blood test in MSK. it’s called the IMPACT, I think. My MO said the same thing”no actionable treatments “

[Ahk1 in reply to Ahk1]

Sorry, I think they run the test on 11/2020 on my prostate that they removed on 12/2012.

[Ahk1 in reply to MoonRocket]

Do you know if these mutations speed up the time to castrate resistant? Thanks

[MoonRocket in reply to Ahk1]

Reading your bio you've been living with your cancer for a while...I would not get caught up in these results, you respond well to treatment.

[Tall_Allen]

It means there is nothing currently available for your only genomic mutation (PTEN loss). Everything else is normal.

[APK3 in reply to Tall_Allen]

Thank you Tall_Allen.

[dhccpa]

Interesting that your doc even ran the test. Where are you receiving treatment? And was test covered by Medicare?

Thanks

[APK3 in reply to dhccpa]

I live here in middle America (Kansas). Dr. suggested right after biopsy. I'm 64 so no Medicare yet. Have decent insurance from my job that I retired from. The blood was sent to the wrong lab. Tempest wasn't the provered provider according to the insurance company. I ended up paying the non covered part. $700. Not a big it but could of been avoided.

[dhccpa in reply to APK3]

Thanks. Frustrating when insurance F/Us occur.

[j-o-h-n]

Good News..........roll up the rug and do a happy dance.........

BTW Get Your $700. back.... don't let them make you pay for their mistake.... That would be a mistake....

Happy New YearS to you and all.

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 12/29/2023 5:44 PM EST