healmymom
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Posts:44
How important is it to have markers determined for a tumor ?
When biopsy was done, not enough live tissue was gotten to do test for markers, even though dr. said he took lots of samples . Our drs. don't seem to think it's a problem to not ever know them, since patient is a smoker, and unlikely he'd have one of the 4 markers that there are targeted drugs for. Would you agree with this thinking ?
Also, do they test for PD-L1 marker before giving Opdivo, or do they just give it as 2nd or 3rd line regardless of PD-L1 marker? Is PD-L1 tested thru only the advanced genetic testing which tests for apprx. 100 diff. markers?
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Reply # - April 27, 2016, 11:25 AM
If you do think that markers
If you do think that markers are very important to know -- would you think a mediastinoscopy would be indicated to take out the lymph nodes including the one that is lighting up to try to get tissue for testing ? Or are the markers not soo important as to do any invasive procedure ?
Sorry for all the questions today -- I'm must trying to separate them so as not to bombard you all in 1 question, but they all pertain to our current confusion. THANK YOU SO MUCH IN ADVANCE
Reply # - April 27, 2016, 06:15 PM
Hi healmymom,
Hi healmymom,
It's certainly true that EGFR mutations and ALK rearrangements are much less common in smokers than in non-smokers, but they do occur. As far as immunotherapies, however, there is evidence that response among smokers may exceed that of non-smokers. And testing may performed for any particular marker.
It's not unusual to perform a repeat biopsy to obtain tissue for additional testing, but whether that would be worthwhile to test for mutations uncommon among smokers is debatable. Testing for PD-L1 expression is not essential, although there is evidence that those with high expression do respond at a higher rate.
On the other hand, given that only one node is lighting up and progression is not clear, it may be premature to perform the mediastinoscopy.
JimC
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