TP 53 Mutation information needed
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Katrina….correct, Merck is running trials not based on molecular alterations with Keytruda, not sure about Bristol‑Myers Squibb and Opdivo.
Phase I: Researchers test a new drug or treatment in a small group of people for the first time to evaluate its safety, determine a safe dosage range, and identify side effects.
Phase II: The drug or treatment is given to a larger group of people to see if it is effective and to further evaluate its safety.
http://www.cholangiocarcinoma.org/punbb/viewtopic.php?pid=104932#p104932Hugs,
MarionThey way I understand it is that metastatic cancer cells and cells of the original cancer usually have some molecular features in common, such as the expression of certain proteins or the presence of specific chromosome changes.
http://www.cancer.gov/about-cancer/understanding/what-is-cancer/metastatic-fact-sheet
Metastatic cells:
have to be able to break away from the original tumor and enter the bloodstream or lymph system, which can carry them to another part of the body.
They need to attach to the wall of a blood or lymph vessel and move through it into a new organ.
They need to be able to grow and thrive in their new location.
They need to be able to avoid attacks from the body’s immune system.Going through all these steps means the cells that start new tumors may no longer be exactly the same as the ones in the tumor they started in.
http://www.cancer.org/treatment/understandingyourdiagnosis/advancedcancer/advanced-cancer-what-is-metastaticHugs,
MarionI’ve been reading media publications lately that indicate that oncologists, pathologists, etc. are seeing evidence that when metastatic tumors appear in organs other than the primary tumor location, the new tumors sometimes do not have the same gene expression as the primary. The thinking is that mutations have occurred.
A dear friend of mine recently lost her mom to cancer. She had lung cancer as a primary. They identified the genetic profile and determined that a certain immunotherapy treatment would be appropriate. At some point, the cancer metastasized to her bones and other organs. Sadly, treatment yielded mixed results. The primary tumors in her lungs showed considerable shrinkage, but the treatment seemingly had no impact on the secondary tumors. This is purely anecdotal, but supports the idea that mutations may occur as the cancer spreads to new locations.
Note: this is based on my limited knowledge obtained from a few articles I have read, and on the experience of one friend. I’m sure there are others on this board that are far more knowledgeable than I, and hopefully, they will share their insigh.
I should restate that my other doctors have asked me to try not to go into a Phase I trial. Also, that there are usually many Phase II and up trials in San Antonio. I also thought I understood that Keytruda wasn’t limited to someone with a certain gene alteration at this time. That’s why they are doing these trials all over the world to see if a certain gene mutation that it works with does show up or not.
Are you saying that our gene mutations don’t stay the same? That your went away and another one cropped up based on a new tumer sample?
Katrina…..I am happy to hear that “your” Medicare covered the expense of Foundation One testing.
That’s great news.
The memorandum report includes the following quote:
“However, genetic tests used to diagnose or determine
treatment in the presence of signs and symptoms of disease can be covered by Medicare.3
A common use of genetic tests in the Medicare population is to assist in determining cancer treatment. Genetic tests can be used to predict optimal chemotherapy regimens
and avoid exposing patients to ineffective or overly toxic regimens.4 “http://oig.hhs.gov/oei/reports/oei-07-11-00011.pdf
I am wondering, has anyone been denied Medicare coverage for this test?
Hugs,
MarionHi Patti,
I do not understand the “ousted” from the Match Trial. Was that an MDA verbal report? Shouldn’t have you received a report saying what all gene testing they compared it to? Or at least how many genes? I think that is a government match and if so, I heard on radio that one may or may not get the resport for a long time.Mine was done through Foundation One (in Boston). I got a nice long report, they named the mutations found (4 of them in my case), how many they tested against and what they were, any meds that are approved for use with those mutations, any trials that include people with one of your mutations. I remember reading that you can receive updates on it as time goes by.
Then they named over a dozen more genes that they are not sure on. Was it not strong enough or ?, I don’t know. My Medicare even paid for this private genetic trial. My MDA surgeon, Dr. Jeffrey E. Lee, requested it. I had heard from a rep at UT Southwest in Dallas that they used them all the time and they were recommended.
Patty-
I am trying to decipher Mom’s results from Guardant360 (blood) testing and this may be way off base, but doing a quick copy/paste in case there is some applicability (It was listed next to TP53)
https://clinicaltrials.gov/ct2/show/NCT02214147
Best wishes,
CatherinePatty…..Novartis is running this trial in Chicago (not yet recruiting) Boston and New York:
https://clinicaltrials.gov/ct2/show/NCT02143635?term=TP53&rank=1
Hoping and wishing for someone else to chime in on this.
Hugs,
MarionI was ‘ousted’ from the MATCH Program basically since I do not fit into any of the “arms” of the trial. Dr. Javle says he thinks immune therapy would be the next step. The only mutation of interest in the report is the TP53 mutation. ANYONE who can chime in here with news about an immune trial for TP 53 would be greatly appreciated. On all the other genomic testing, I had the FGFR2 and P-Ten mutations. They are gone and we have changed to TP53. It’s hard to keep up on what you have and don’t have
Feeling anxious and now need to redirect my studying of mutations now to TP53!!
Happy New Year!!
Patty in Illinois
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