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Help with Understanding Mutations


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My husband had genetic profiling which the oncologist is waiting to tell us about. Is anyone familiar with these to offer advice:

EGFR L858R, KRAS Q61R, MSS, PD-L1 0%.

Thank you all in advance

   (He was started on Tagrisso, which worked for about 8 months, got 2 months of traditional platinum/Pemetrexed chemo, which didn’t help, so is now trying a clinical trial

  for an HER3 mutation he also has.  Trial not going so well.

Thanks much 


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The EGFR L858R is an Exon 21 gene mutation that is usually treated with Tagrisso (as well as Exon 19 deletion). There are several KRAS subtypes, and the Q61R is one. I don't know whether it is a targetable mutation. I'd never heard of MSS, but a search says it means microsatellite instability. 

PD-L1 means programmed cell death ligand. They test for PD-1 and PD-L1 to determine if immunotherapy is a possible treatment. 

This is all complicated stuff, and your husband's oncologist is best suited to sort this out for you, as well as next steps. I'm sorry your husband had progression on Tagrisso. 

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I'm glad you found us, the information you have represents how complicated lung cancer treatments can be.  I would recommend reaching out to the Lung Match Program at the Go2Foundation.  They have a team of dedicated researches who are skilled in helping to identify potential treatment plans and clinical trials when there are multiple mutations identified.   I've had some group members who had multiple mutations who used the Lung Match program to identify a successful clinical trial the department chair at our academic cancer center didn't know about.   There's just too many trials for any one doctor or health system to know about.    Please keep us posted. 


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