Target therapy

[pmilmidiai]

Has anyone had a target therapy done on their cancer cell?

[scifiknitter Blogger]

I'm not sure what you are trying to find out. There are lots of lung cancer patients now who have taken targeted therapies - such treatments are the preferred first-line treatment for patients with the EGFR, ALK and ROS1 mutations in their cancers. I am on my third drug for EGFR mutations, one that is acting on a resistance mutation (T790M) that developed during my first line of treatment.

Anita

[TraClo in reply to scifiknitter]

Anita how is it going for you ? What therapies have you been treated with ? Live Tracey x

[scifiknitter Blogger in reply to TraClo]

Tracey, as I said above, I tested positive for the EGFR mutation after diagnosis from a tissue biopsy taken from my pleura. I was on Tarceva for 10 months, and developed resistance. I had another tissue biopsy, from a lymph node in my neck, and tested positive for the T790M mutation, a resistance mutation that developed while being treated with Tarceva. I then went into a clinical trial for CO-1686, a drug being tested by Clovis. After 8 months, I could no longer tolerate an effective dose of this drug (which has since been pulled from development and will never go to market). At that point I started taking Tagrisso, which had recently been FDA approved. I have been on Tagrisso for 11 months now and am doing well - feeling good, and the cancer is ccurrently stable. Alive and feeling well 31 months after diagnosis!

Reading your reply below, I see that your husband is also EGFR. Very glad to read that he is handling the side effects well, they can be challenging. I dealt with much the same with Tarceva. Tagrisso is more tightly targeted and while I have some Tarceva-like side effects, they are much milder than what I experienced with Tarceva.

[pmilmidiai in reply to scifiknitter]

EGFR, how do I find the type I have. So many names, so many initials I can't keep up.

[scifiknitter Blogger in reply to pmilmidiai]

Lung cancer patients with adenocarcinoma find out if they have a mutation from a biopsy - usually a tissue biopsy done soon after diagnosis. 4 tests have become pretty much standard, because there are approved treatments for them - EGFR, ALK & ROS1, also PD-L1 which isn't actually a mutation, but is a biomarker that can indicate whether immunotherapy is likely to work.

Some patients have an extensive genetic analysis done that reveal mutations other than the ones I list above. There may well not be treatments available, however, for other mutations such as KRAS.

Mutations play a role with treatment decisions almost exclusively with adenocarcinoma. While the treatable mutations sometimes show up in patients with other types of cancer, but that is very rare.

[Enjoyabull in reply to scifiknitter]

Can they identify the mutation simply by a biopsy of an affected lymph node or do they need to test the tumor?

[scifiknitter Blogger in reply to Enjoyabull]

Yes, in fact that's how they did my second biopsy.

[JFreemanDaily Special Guest in reply to Enjoyabull]

Mutations can sometimes be found by testing pleural fluid as well.

[Enjoyabull in reply to scifiknitter]

How do you find out this ? I had one biopsy done of one affected lymph node and it didnt show anything. This was a year ago. What is a resistance mutation?

[scifiknitter Blogger in reply to Enjoyabull]

Your doctor would have let you know if they found out anything in that biopsy that they could use in your treatment.

A resistance mutation develops while a patient is being treated with targeted therapy. The cancer mutates in a way that prevents the drug from working any more.

[TraClo]

yes my husband us on giotrif for stage 4 lung cancer and us 3 months i to this with xt scan results this Thursday so fingers crossed for good news. He's managing side effects well so far after a challenging start. What target therapy are you looking into? Happy to link in. Love Tracey x

[scifiknitter Blogger in reply to TraClo]

Best hopes for good scan results!

Anita

[TraClo in reply to scifiknitter]

Great scan results today the giotrif is working very well and the tumours have shrunk and so we are very pleased and hope the medication continues to work. Thank you for your support. How are you? X

[scifiknitter Blogger in reply to TraClo]

Hooray! I'm doing quite well at the moment - 2 scan free months ahead and I'm living my life.

[Simpy57]

I have been on a couple targeted therapies for my ALK mutation. Taking pills everyday instead of platinum based chemo is so much easier and the side effects are not anywhere as harsh. What mutation do you have?

[pmilmidiai in reply to Simpy57]

I don't know about any mutation. Where do I fine that....?

[scifiknitter Blogger in reply to pmilmidiai]

It's standand practice to get a biopsy and test newly diagnosed stage 4 patients with adenocarcinoma for possible treatable mutations: EGFR, ALK, ROS1. It is becoming more standard to rebiopsy and retest when one of these types of cancer starts to grow again because new mutations can develop during treatment that block a drug from working any more.

Testing for mutations is much, much less commonly done with squamous cell and small cell cancers. These cancers very rarely are driven by a treatable genetic mutation.

[pmilmidiai in reply to Simpy57]

I do not know the mutations. I should find out next Thursday the 26th.

[Collinjo1]

Radiation therapy and chemo designed to shrink tumor on left lung. Tumor was shrunk.

[Denzie Moderator Volunteer]

Your oncologist will share the information with you when it is received. Mutation testing is done routinely for stage 4 cancer only. It takes several weeks to get results back.

A cancer forms because there is a breakdown in the DNA strands when the cell splits. The cells continue to split indefinitely allowing masses to form. You may remember the double helix if DNA from science classes. The specific spot the DNA breaks down along that ladder-like double helix names the mutation. When a medication is developed that helps prevent cells with that particular breakdown from occurring you have a targeted therapy.

[Diamajoy]

Yes I have used tarceva and now on tagrisso.

[JFreemanDaily Special Guest]

Although tumor testing is now standard of care in the USA for non-small cell lung cancer, a recent study found many eligible patients are still not getting tested. It's important to have a conversation with your doctor about what tumor tests were done on your tissue and what mutations (if any) were found. Ask for a copy of your pathology report.

If your tumor was NOT tested for all the currently known mutations (especially EGFR, ALK and ROS1), you might still get useful information from testing your archived tissue samples even if your cancer has been treated with chemo and radiation. It worked for me!