MET amplification

[jack14]

I have been advised that although the use of Crizotinib has only been approved by the FDA for the MET 14 mutation, that it has been used for MET amplification with some success in trials. My Oncologist says that although I have that marker, and it's the only one that has any potential for targeting at this time, she isn't confident that the VA will approve it. I will know Monday if the Keytruda isn't working anymore and we may be looking at this, or chemo as our next line of therapy.

I have also been advised by a represenative at GO2 Foundation that one can develop targetable mutations that were not identified before a course of treatment was administered. I am not sure that the VA or Medicare would approve of a second genetic assessment or not. But if they did, can they use my blood to get an updated panel of genes from rather than having to excise or aspirate another lymph node specimen?

[Tom Galli]

Jack,

Sorry I am late with this response.

Is the oncologist you mention in your post a VA oncologist? If so, once inside the VA treatment wall, there are many ways of navigating a treatment approval issue. Let me know of your Monday results.

On your advise about developing targetable mutations post treatment, yes this happens. Lung cancer mutates and those in targeted therapy often learn their lung cancer found a path around the treatment. As for a blood biopsy vice needle or surgical biopsy, the former can be inaccurate. If you have progression and if your oncologist suspects mutation, it is wise to have the most accurate form of biopsy available. Unfortunately, this is not yet a blood biopsy. 

Stay the course.

Tom