I'm writing as my mom (60, lung and some bone mets from breast cancer, now over 2nd line chemo with Taxol after Faslodex failed) is looking at multigene testing to see what therapy can work next (I'm not sure I am writing this down right). Obviously, the insurance won't cover it, it's super expensive and once we have the results, the drugs recommended might not even be in our country (Romania), and we won't be able to afford to go elsewhere. Has anyone done more testing on their tumor? (other than the hormone receptors)? Is it worth it? I'd love to hear about your experiences!
Many thanks and hugs to you, inspiring community!
Tue, 06/12/2018 - 06:39
Multigene testing has been shown to have value for some purposes, such as assessing hereditary risk of breast cancer as well as the risk of relapse. But in terms of predicting which treatments are more likely to be effective, the evidence is not yet strong enough to warrant much confidence in such predictions (other than specific mutations for which there exist targeted therapies). As stated in this article from Breast Cancer Research:
...drug-specific treatment response predictors also remain elusive. Emerging areas of research involve the development of immune gene signatures that carry modest but significant prognostic value independent of proliferation and ER status and represent candidate predictive markers for immune-targeted therapies. Overall metrics of tumor heterogeneity and genome integrity (for example, homologue recombination deficiency score) are emerging as potential new predictive markers for platinum agents. The recent expansion of high-throughput technology platforms including low-cost sequencing of circulating and tumor-derived DNA and RNA and rapid reliable quantification of microRNA offers new opportunities to build extended prediction models across multiplatform data. - https://www.medscape.com/viewarticle/842206 (with free registration, you can view the entire article).
So unfortunately at this point, using multigene testing to choose a therapeutic agent is still a work in progress.