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PIK3CA test , aspirin and prognosis

sdp's picture
sdp
Posts: 151
Joined: Jan 2012

I am KRAS wold type and am currently on erbitux maintenance chemo.

My doctor has also recently started me on low dose aspirin (75 mg) daily after my resection of colon and liver. He advised that I should get the pik3ca test done.

The test is done on the tumour sample and the test has me identified as pik3ca mutation in exon 9.

The prognosis of persons who are KRAS wild type and having pik3ca mutations not very good for overall survival , it seems. However, use of aspirin for mutated pik3ca indicates better survival statistics. This is what I read when I do a search. Also, there are some papers indicating that only if exon 9 and exon 20 are both mutated in the pik3ca test then the prognosis is not good. If someone has one mutation then there is no such bad prognosis. Also for pik3ca mutation in exon 20 it seems that biologics like erbitux ( EGFR affecting drugs) don't seem to work for reduction of tumour etc.

Has anyone got this test done and can advise me or throw some more light on this matter?

Sdp

tanstaafl's picture
tanstaafl
Posts: 970
Joined: Oct 2010

We went with the 1/4 aspirin (81mg), strengthening the body nutrionally, and then focused on finding and treating more biomarkers, as well as better chemo.

renw's picture
renw
Posts: 282
Joined: Jan 2013

I had the pik3ca test done but had to fight with my oncologist to get it. In Australia this is a non standard test it seems especially since I had positive KRAS test and the onc insisted that it was a waste of time. Well, I was armed with the aspirin meta study which he did not know about which indicated a positive effect of aspirin with this mutation. He dismissed it initially not really bothering to take a look even.

When my pik3ca came back positive, the lab result quoted the aspirin study and that it can be beneficial in terms of OS. My onc finally took it seriously and looked up the study. He then recommended I start taking aspirin that it is worth the risk, despite being on avastin at the time.

I also fought to get BRAF and NRAS done and in the process of organizing HER2. I feel the more info you have the better as there are various therapies available that target specific mutations, such as Herceptin usually used to breast cancer for HER2 cancer types. There is a 11% chance that colorectal cancer will be HER2 positive for example and knowing this opens up additional treatment options, but you really need to push your oncologist otherwise they just tend to follow the standard protocols.

Ren

pete43lost_at_sea's picture
pete43lost_at_sea
Posts: 3915
Joined: Nov 2010

thats a great reply, raised this last november, got nowhere as i was in germany. getting all these tests done asap before heading overseas is wise.

the her2 test cost $140 out of pocket, not covered medicare. even if slight her2 expression the new her2 antibody are available after removab.

hugs,

pete

coloCan
Posts: 1850
Joined: Oct 2009

 

Is your reference to aspirin from this article here at the New England Journal of Medicine?

www.nejm.org/doi/full/10.1056/NEJMoa1207756

or 

www.nejm.org/doi/full/10.1056/NEJMc1214189?viewType=Print&viewClass=Print

entitled "Aspirin,PIK3CA Mutation and Colorectal-Cancer Survival".....If not , perhaps you might want to check some of the references cited for more info Also,seems like aspirin could be of benefit if mutation of PIK3CA

 

 

The site plosone.org will provide you rather technical stuff on Kras,Braf,PIK3CA,MSI,etc

annalexandria's picture
annalexandria
Posts: 2263
Joined: Oct 2011

although I never had this test (in fact, had never heard of it until now).  I don't take anything else that thins the blood, so it seems like a relatively safe thing to add just on the off chance that it will make a difference.  Ann Alexandria

coloCan
Posts: 1850
Joined: Oct 2009

use of aspirin and macular degeneration, at

www.medpagetoday.com/ophthalmology/generalophthalmology/36943

 

(its in middle of page)

 

 

 

 

Sundanceh's picture
Sundanceh
Posts: 4302
Joined: Jun 2009

I was just going to post this for Ann...and saw you already had it going on.

 

 

janie1
Posts: 753
Joined: Apr 2011

2013-01-22

annalexandria's picture
annalexandria
Posts: 2263
Joined: Oct 2011

You know what is totally weird?  My eyes have gotten wonky this last month.  I have horrible eyesight anyway, but I've been getting these weird flashes of light around the edges of my eyes.  I was planning on getting them checked out pretty soon.  I don't know if it's related or not, but THANK YOU for posting this.  My dad lost virtually all of his eyesight due to this condition, and for a guy who loved his books (as do I), it was an absolute nightmare.  I don't think the evidence for taking aspirin is strong enough to keep me on it, given this risk.  Damn.  Is there anything out there we can take without having side effects?  I couldn't even do tumeric, because it was too hard on my system.  Oh well, thanks again for the info.  This board is a veritable font...AA

PS You're right, Janie, that it's not a definite thing.  Typical study in that there are a lot of maybes, etc.  But the thought of damaging my eyes is so disturbing that I think I'll pass on the aspirin, at least for a while.

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