PIK3CA test , aspirin and prognosis

sdp
sdp Member Posts: 181
in Colorectal Cancer #1
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

Comments

  • tanstaafl
    tanstaafl Member Posts: 1,313 Member
    #2
    use of time and money

    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
    renw Member Posts: 282 Member
    #3
    I had the pik3ca test done

    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
    pete43lost_at_sea Member Posts: 3,900 Member
    #4
    renw said:

    I had the pik3ca test done

    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

    welcome ren

    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
    coloCan Member Posts: 1,944 Member
    #5
    Aspirin and PIK3CA

     

    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
    annalexandria Member Posts: 2,571 Member
    #6
    I take a baby aspirin every day...

    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
    coloCan Member Posts: 1,944 Member
    #7
    annalexandria said:

    I take a baby aspirin every day...

    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

    No cause for alarm here but this just came out on long-term

    use of aspirin and macular degeneration, at

    www.medpagetoday.com/ophthalmology/generalophthalmology/36943

     

    (its in middle of page)

     

     

     

     

  • Sundanceh
    Sundanceh Member Posts: 4,392 Member
    #8
    coloCan said:

    No cause for alarm here but this just came out on long-term

    use of aspirin and macular degeneration, at

    www.medpagetoday.com/ophthalmology/generalophthalmology/36943

     

    (its in middle of page)

     

     

     

     

    Right, Steve

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

     

     

  • janie1
    janie1 Member Posts: 753 Member
    #9
    Sundanceh said:

    Right, Steve

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

     

     

    which is the greater risk? cancer? long term use says over 15

    2013-01-22

  • annalexandria
    annalexandria Member Posts: 2,571 Member
    #10
    coloCan said:

    No cause for alarm here but this just came out on long-term

    use of aspirin and macular degeneration, at

    www.medpagetoday.com/ophthalmology/generalophthalmology/36943

     

    (its in middle of page)

     

     

     

     

    Holeeee cow!

    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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