I was diagnosed from a lymph node biopsy in early February of this year. After many tests I've have NSCLC stage IV with brain metastases. They just finished radiating the tumors in my brain and starting treatment after wash out period in a clinical trial. How do I search for clinical trials based on my genetic testing? Based on the details of my report, would I research ONLY trials for PIK3CA? Is there anything else in the report I should search on for potential trials?
The genetic testing showed the following genomic variants and how they were categorized in the report:
Potentially Actionable - PIK3CA (variant allele fraction - 16.3%)
- TP53 (variant allele fraction - 39.8%)
- ZFHX3 (variant allele fraction - 11.1%)
- CCNE1 (copy number gain)
Pertinent Negatives - EGFR, KRAS, BRAF, ALK, ROS1, RET, MET, ERBB2 (HER2)
Immunotherapy Markets - Tumor mutational burden - 11.6m/MB 90th percentile
Expression Details - ERBB3 over expressed
Wed, 04/06/2022 - 13:01
Just your luck, I'm so sorry you've found yourself having to find options.
I don't know how familiar you are with clinical trials or our posts and videos on the subject so here are some relivant posts.
From our 2020 targeted therapies forum, Rare Mutations Q and A. There are several other vids on the subject towards the bottom of that page.
We also have a comprehensive series on clinical trials, Understanding Clinical Trials.
If you don't already know about ClinicalTrials.gov it is a comprehensive database of all clinical trials with an excellent search features.
I will get back to you in a bit but this should get you started.
Wed, 04/06/2022 - 19:44
When searching on clinicaltrials.gov try using solid tumors as a search term in addition to nsclc. I didn't find anything past your "potentially actionable" mutation. The best place to find where to find clinical trials is probably at a large academic research center that has a specialty in lung cancer and targeted therapies. ERBB3 is also known as HER3 but don't think that will help as I didn't find anything using it either. Even if the oncologist doesn't have specific knowledge of an appropriate trial they will probably know who or where to ask for you. It's best to have a specialist's input who knows your specific info. This is an excellent post that describes how and why to get a 2nd opinion.
You're doing the right thing by looking into clinical trials prior to starting typical 1st or 2nd line treatments. Many trials for various reasons exclude those who have had other specific treatments. Trial or not some targeted drugs have caused critical side effects when given after immunotherapies at least for egfr tki's, so that would be something to talk about if/when you use an immunotherapy.
Let us know as questions arise and if I've not covered what you're looking for.
All the best,
Tue, 04/12/2022 - 08:13