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Hi Lungevity friends. Have a question


D iane

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How accurate is a liquid biopsy test to determine a biomarker?

Have a good friend in the beginnings of a Stave IV diagnosis.  They have her set to start treatment next week, but the biopsy she had was a lymph node in her neck, so I don't think they are really sure of origin.  The oncologist she has (Penn Med-Abramson Cancer Center) feels confident starting this treatment which includes 2 chemos (not sure which ones) and Keytruda. I've  read here though, over my time, that sometimes that didn't help. No PET or brain MRI yet but coming up.   I'm not trying to be overbearing, just would like to lend any insight in the event she asks me.  Thanks.  Do they just start treatment not really knowing what they're treating?

 

I'm so glad to see so many of you doing as well as can be.  I read here still sometimes.  I miss my husband still, but doing OK.  I'm due for a CT scan of my lungs in December and I don't want to know anything about my lungs!  They write more stuff in each report. 

Thanks for any input.  I thought once rolling and perhaps feeling better I would encourage my friend to join.

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Hi Diane, 

Welcome back, glad to hear from you and sorry to hear about your friend.  I remember your posts well, thank you for advocating on your friend's behalf.  I've been knee deep in some of the latest research.  Blood biopsies are very accurate these days, however, there are exceptions and tissue biopsies coupled with comprehensive bio marker panels are still considered the gold standard.   Not all biopsies are created equal either, for example, there are four different tests for the ALK mutation, while the four tests concur 95% there's still a 5% margin of error.   While it's not a perfect prediction, the blood biopsy is a good launching point.  The PET and brain MRI should come before any chemo to determine if radiation would be an effective course of therapy in addition to chemo.  

As for starting treatment before testing, that all depends on the severity of the patient's symptoms and general physical health status.  I did start the triplet immediately while results were pending because I was critically ill and rapidly deteriorating.   The chemo combo was a stop gap until the treatment plan could be finalized.  

Hope this helps.  Thanks so much for checking in on us.  You've been missed! 

Michelle 

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Hi, Diane,

From what I understand, there are some ways in which liquid biopsies are preferable and others where tissue biopsies are preferable--I had both. 

I'm treated at U. Penn/Abramson, and they are definitely all over the latest treatments. There's a good chance they are talking about the triplet--Carboplatin, Alimta, and Keytruda, which is a standard first-line treatment--at least if you have no targetable mutations. 

What do your friend's scans show? I'm assuming she has a lung nodule/tumor if they are treating her for lung cancer. And a biopsy of the lymph node should show what kind of cancer it is. Have her ask if they are ordering molecular/genetic testing to check for mutations (in addition to liquid biopsy). I had both.

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Diane,

You've already got your question answered so I'll just say that it is good to hear from you again and to know that you are doing okay and even looking after your friend.  That's super.

Lou

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You guys are the best.  Thank you!   Feel better now knowing this triplet she will be starting while still figuring things out is OK.  She's in a good place @ Penn, I'm certain they are all over it.

She is at home, working some, and coughing up a storm.  She was given a hefty dose of steroids, and a puffer, hopefully these will help keep her home for the next week until treatment starts.  It's been a few months of in and out of the hospital and generally not feeling well.  As hard as it is for her to be going thru this, she is finally on the right track.  I'll keep you posted.  Thanks again!

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Lexie I just came across an article you posted back in May regarding the testing and starting treatment.  When I spoke to my friend earlier this week, she is starting treatment tomorrow, but just the doublet chemo.  No immunotherapy until her Guardant test comes back.   Smart move on their part.

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  • 1 month later...

I'm sadden to have to tell you all that I lost my good friend and former co-worker last Thursday.  She didn't even have the bio marker results back yet.  As many you have experienced with this awful cancer is you can be asymptomatic for a long time. Most lung cancers are found incidentally from other tests, OR you become symptomatic and by the time you go through the diagnostics you are stage IV.  

Anyway, sending you all my best for a happy holiday.  Stay well as you can be.

I've been working from home all week.  Negative for covid, probably a slight bit of bronchitis or just sinus.  I'm scheduled for my lung cancer screening next week. Tests make me anxious, however, it could possibly be a signal should anything show up.  Hoping I don't have to return and report anything concerning.  I also joined Penn Medicine's Healthy Lungs Program being a sometimes and former smoker.  Hope to stay quit for a very long time now.  I'm done.  I'm so sorry for those of you who never smoked, and still got this disease.

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Hi Diane,

I’m so sorry… on all fronts.  I just wrote an Op-Ed in the KC Star about the heart of the issue you have raised in that cancer is a sneaky disease which can strike anyone at anytime without warning.  It’s just not fair your friend didn’t get diagnosed sooner.  There’s so much technology available right now for early detection which is being held up by Congress and other government bureaucrats.   It’s heartbreaking.  
 

I’m relived your Covid test was negative, as you know bronchitis can be really serious and linger on.  It’s a smart move to get involved in the healthy lung program.  As you have learned along the way there is a limited defense in this game so we must be on a full frontage offense.  What you are doing takes real courage and I admire you for it.   
Please keep us posted and stay in touch as I really enjoy reading your posts. 
Take good care, will be in my thoughts and prayers. 
Michelle

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Diane,

Sorry to hear about your friend's passing.  That is so sad.  Michelle already touched on the obvious; that we should stop "waiting for cancer" and instead proactively check for it.  We also hear you on upcoming scans.  Funny, when it's time for scans I feel anxious and in between the scans I get nervous because of passing time.  It's not an easy road for us, is it?  But at the end of the day we have to choose to live and that is what I decide to do.  So, take care, keep yourself occupied and please let us know the results of your scans?  

Lou

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Hi.  I was so sad I had to miss my friends memorial service due to sickness.  Getting better everyday. Looks like I did have some bronchitis.   Wanted to stop in and share my low dose CT screening, I passed. YEAA!

IMPRESSION:

1. Lung Cancer Screening ACR LungRADS Category: 2 - Negative findings with a benign appearance or behavior with a very low likelihood of becoming a clinically active cancer.

Recommendation: CT Chest Screening for Lung Cancer in 1 Year

2. Potentially Significant Incidental Findings: No . No new or previously unknown potentially significant incidental findings requiring additional evaluation.

3. Other incidental findings as below.

FINDINGS:

Lung Screening Specific Findings:

Nodule #1: Stable left upper lobe 2 mm solid pulmonary nodule on image 20 of series 2.

No new or enlarging pulmonary nodule.

Potentially Significant Incidental Findings:

None

Incidental Pulmonary Findings:

Subpleural radiation changes in the anterior left upper lobe.

Findings of chronic bronchitis. Mild scattered subsegmental atelectasis.

Other Positive Incidental Findings:

Coronary artery calcifications are present. Postsurgical changes in the left breast.

 

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