BRCA1 and CDKN2A

[robinef206]

Hi everyone! My dad was diagnosed in 2011 with IB adenocarcinoma. Underwent wedge resection, without need for chemo or XRT. Fast forward to 2016, when he underwent a CT scan to check on his (for now) stable aortic aneurysm, and they discovered 3 enlarged lymph nodes. Found to have IIIB adenocarcinoma. Underwent chemoXRT. PET in Oct revealed excellent response to the chemoXRT, however, we unfortunately missed the "curative intent" boat, as the cancer had already spread to the liver (too numerous to count), possible bony mets and possible lung nodules. So far, he had been asymptomatic entirely, outside of the side effects from the chemoXRT. He does not have your typical mutations, so onc recommended starting Opdivo, as he feels it works just as well, if not better than, standard chemo with fewer side effects.

The jury is still out regarding Opdivo, as he's only had one infusion. As soon as he had the infusion, he immediately started feeling symptomatic, unclear if it's from the disease or the tx. Substantial increase in fatigue, dysguesia, queasiness, and feverish. I'm not even sure he has the PDL-1 expression. Anyway, I'm asking about BRCA1 and CDKN2A mutations. Does anyone know much about these? The doc felt that if Opdivo doesn't work, we could potentially try olaparib or palbociclib instead. These have been approved as targeted therapies for recurrent ovarian and I think breast cancer. I haven't found much research on lung, except for ongoing some clinical trials in SCLC. Does anyone have any information, either anecdotally or clinically, about these mutations and using the other drugs?

Thanks so much! By the way, I'm getting married in January, and in lieu of gifts, my fiancé, sister, and brother in law have decided to donate money to this awesome organization. We are hoping we can contribute to a path toward better treatment options.