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Genetic testing


Granmaof3

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Could someone please explain the following lung cancer genetic testing please. ALk negative ROS1 negative EGFR negative PDL1 positive at 20% does this mean targeted therapies and immunetheraphy will not be offered. My husband 3 days away from finishing radical therapy they didn't include the chemo with it because of the corona virus. But his oncologist said that was the plan 2 chemo drugs and I'm sure he said an immunetheraphy drug to be included. I just need to be more prepared to ask questions from his oncologist. Thank you 

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This is only a partial genetic panel, ask the oncologist to do a full panel.  There are two ALK tests, one more sensitive than the other. There are other mutations though rare such as NTRK or BRAF that have pills aka targeted therapy available.  In total there are nine targeted mutations. 
 

The chemo combo is a triplet of Carboplatin, Altima and Keytruda which is now standard of care when there are no known mutations.  
 

Hope this helps

Michelle

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Michelle Thank you so much I will ask the oncologist when we see him. I do appreciate you're quick response if I can just ask if the chemo/immunetheraphy cocktail doesn't t work should I be asking for retesting of these markers before he starts another combo. 

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Generally the genetic panel is completed when there is a recurrence.  Fortunately there has been more advances in lung cancer treatment in the last five years than in the last fifty.  If the first combo doesn’t work, then the doc has more in the tool bag. 
It’s an important question to ask what plan b is and to understand  the process. You might also want to ask if there are any clinical trials where many treatment breakthroughs are occurring.  

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  • 3 weeks later...
1 hour ago, LUNGevityKristin said:

How are you doing, Granmaof3?

Hi Kristin just sent an email to my husbands oncologist as he finished radiotherapy 2 weeks ago and has an appointment with his oncologist 1st July which will be 8 weeks. I know they have to wait 6 weeks for the inflammation to settle down but thought he could start his chemotherapy before that. I haven't read anything online that says chemotherapy cannot be started before his scan. And the original plan was to do radiotherapy and chemotherapy at the same time. But because of the corona virus it was suggested to just do the radiotherapy. 

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