KEAP1 & STK11

[GARhodes]

I have been searching the forums for anyone (like me) with STK11 and KEAP1 mutations. Seems like a tough set of mutations to figure out a workable treatment, with no targeted drugs, but also bad outcomes for chemo and also PD-1.  Anyone out there dealing with the same?

[Tom Galli]

GAR,

Welcome here.

I've just spent a hour searching for papers on STK11 and KEAP1 KRAS mutations and immunotherapy. I didn't see information about bad outcomes for conventional chemotherapy but these driver mutations do predict unfavorable outcomes for immunotherapy treatments.

Adenocarcinoma with the KRAS mutation is a challenge. Here is some information on KRAS and drugs developed or in development to treat it. (Read in particular at the right arrow (>) "Treatment options."

Have you had a consultation with a radiation oncologist? There are several on this forum with KRAS mutations that do not respond to Targeted Therapy or Immunotherapy who've had precision radiation (SBRT or SABR) for multi-focal (several widely spaced) tumors. One needs to find the right radiation oncologist but blasting tumors with high doses of precisely focused radiation does fry the tumors and may start the abscopal effect. Here is some information about external beam radiation therapy (EBRT) (read the right arrow [>] "How radiation therapy is administered." Then read about the abscopal effect (the right arrow[>] "What is the abscopal effect?"). Here is a blog from a forum member Roz who is benefiting from precision radiation and the abscopal effect treating her KRAS G12D mutation.

Stay the course.

Tom

[Roz]

Hi GarRhodes,

I was wondering which KRAS mutation you have? Unfortunately, I don't know about the STK11 and KEAP1 mutations.

Also, what is your PDl-1?  When and how were you diagnosed?

I'm happy to help with questions. I wrote the blog about "Roscopel affect."

 

Best,

Ro

 

[Rower Michelle]

Hello and Welcome. 
One of our group members had the KRAS & STK11 mutations.  He worked with the Go2Foundation to locate a clinical trial.  It’s a rare combination mutation that you might want to consider getting a second opinion at one of the “big” centers… even though you’re in a major metro area, it’s worth contacting MD Anderson and Mayo. 
 

Lung cancer is complicated to treat and we’ve found educated patients do much better… it’s impossible nowadays for oncologists to keep up with the emerging science which is good news for us.  It is up to us to seek out the latest… the cancer center teams are so busy looking at what’s happening in the day to day it’s hard for them to keep abreast of the latest developments.  It’s not a criticism of the medical team- we all need to work together and believe me when a patient finds something new through either expert opinion or from Lungevity or Go2Foundation, they are genuinely happy for us.   
Michelle