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Targeted Cancer Care page at MGH

Mikenh's picture
Mikenh
Posts: 777
Joined: Oct 2017

I answered a few questions on BRAF and KRAS variants last night on another board after doing a a lot of research and asking my son to interpret a paper for me. I have a much better understanding of the big picture of CRC now. This morning I was looking around and found that Mass General Hospital (MGH) has pages by variant and they describe the type of cancer (CRC in this case), the Mutation (KRAS in my case) and the Variant (G12D in my case). They also provide a list of clinical trials related to the variant. They have these pages for a whole bunch of variants and I assume that they have them for the various Mutations as well. You'd need to have genomic analysis of the tumor to know this stuff unless it's something like MSI-H where there are IHC tests that can determine that. Knowing that I have G12D means that two treatments (anti-EGFR growth) are off the table since they don't work. The pathologist told me this in his email but I didn't understand the link at the time. The site for KRAS G12V is here (the person on the other forum asked about this particular variant):

https://targetedcancercare.massgeneral.org/My-Trial-Guide/Diseases/Colorectal-Cancer/KRAS/G12V-(c-35G-T).aspx

 

MyJourneywithCancer
Posts: 83
Joined: May 2017

Inspired by your reading, I came across this clinical trial (hosted by NIH and currently recruiting) specifically addressing KRAS G12D mutation:
https://clinicaltrials.gov/ct2/show/NCT03190941

Mikenh's picture
Mikenh
Posts: 777
Joined: Oct 2017

Thanks for looking but the link I posted is for G12V as is the clinical trial. I wouldn't be elegibile because they just cut the tumor out of me last week. I think that the standard course of treatment works quite well for KRAS variants unless it spreads. The trial uses custom stuff - they take some of your cells and make the treatments from them and that costs a huge amount of money. I'd guess that they reserve it for stage 4 patients as they need it the most. I'll take a peak at G12D trials though - G12V and G12D are similar. G12D converts glycine to aspartic acid while G12V converts Glycine to Valine.

Mikenh's picture
Mikenh
Posts: 777
Joined: Oct 2017

There is a trial at https://targetedcancercare.massgeneral.org/My-Trial-Guide/Clinical-Trial/NCT02079740.aspx?context=/My-Trial-Guide/Diseases/Colorectal-Cancer/KRAS/G12D-(c-35G-A) but it requires that you be stage 4 and/or have unresectable cancer. I do think that's the way it should be - save the most advanced treatments for those that need it the most. There's also the safety and efficacy issue - if your course of treatment is working, then there may not be a need to take on the risk of a trial drug. I think that those at Stage 4 have less to lose from the trial.

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