Wild type Lung Adecarcinoma - 1261289

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Wild type Lung Adecarcinoma - 1261289

Dear Dr West,

My husband has been diagnosed with lung adenocarcinoma in sept 2013. Currently on chemo. Initial diagnosis was T2N2m0. After 4 rounds of chemo, had a CT Scan and the result are in next para. From total 3 tumours, 2 has totally disappeared, and the 1 left had 80% shrinkage. So basically, hubby has 20% tumor left in him. Oncologist said his cancer I aggressive and needs whole life maintenance?.this is the same oncologist who few month ago said he will cure my husband via surgery after chemo.

" Diagnosis: Stage 3C/4 non-small cell lung adenocarcinoma (left lower lobe mass with hilar/ mediastinal nodes, EGFR, EML Alk4 wild-type). Commenced Carboplatin, Taxol and Avastin. November 2013 – excellent response with substantial reduction .

My question is, base on his report above what is his mutation? I need to prepare myself for questions before hand.

Treatment is in UK, we live in Korea which offer proton therapy and immunotherapy. We are thinking of going back to Korea to continue there..

Your help and input is highly valued..

Reply To: Wild type Lung Adecarcinoma

Wild type is usually associated with the K-RAS mutation. There's no way to tell what mutation he has from what you've included other than possible K-RAS wild type. He's had a good response to chemo so congrats.
The rest is for a doctor to respond on. Wishing him the best. Take care, Judy

Dr West
Reply To: Wild type Lung Adecarcinoma

Actually, wild type just means "no mutation" with regard to a specific gene, so what is written in your report is that there is no evidence for either an EGFR mutation or ALK rearrangement. It doesn't say anything else about other mutations, but right now EGFR and ALK are the two main mutations associated with a change in treatment recommendations to favor oral targeted therapy in patients with one of these mutations, vs. chemotherapy-based treatment for those who don't have a mutation ("wild type" for EGFR and ALK).

It's great that he has responded so well. There really is no role for proton therapy in advanced/recurrent NSCLC. Immunotherapy, while a promising avenue of clinical research around the world, is still of undefined value compared with conventional chemotherapy or other off-protocol treatments.

-Dr. West

Dr. Howard (Jack) West
Associate Clinical Professor
Medical Oncology
City of Hope Cancer Center
Duarte, CA

Founder & President
Global Resource for Advancing
Cancer Education

Reply To: Wild type Lung Adecarcinoma

Dr West and Judy,

Many thanks for your reply. We are now compiling questions to ask our oncologist including treatment options if we can continue outside UK. Now it is a bit clear for me regarding mutations and wild type, thank you very much.