Genetic test could guide use of cancer chemotherapy

Medical Xpress / Imperial College London / Nature Medicine ^ | March 2, 2023 | Ellie Cawthera / Joris van de Haar et al,l

[ConservativeMind]

Researchers found [a] test can predict whether a bowel cancer patient will benefit from chemotherapy. It is thought that this could spare patients who will not benefit from treatment from unnecessary toxicity and debilitating side effects.

The genetic test is already used as part of standard of care in the UK and worldwide to predict patients' responses to other targeted cancer drugs, meaning doctors could apply it to guide chemotherapy straight away. In bowel cancer, responses to last-line chemotherapy treatment trifluridine/tipiracil vary greatly between patients—with some patients showing good, long-term responses, and others seeing no benefits.

The researchers found that a specific mutation in the KRAS gene called KRASG12 was linked to poor survival in treated patients. Conversely another mutation was linked to a three-fold increase in survival.

"It will be difficult for some patients to find out that this last-line drug will not benefit them, but this test will mean they are able to avoid unnecessary side effects and have a better quality of life with advanced cancer. Fortunately, our findings also reveal a group of patients who see substantial benefits from taking this type of chemotherapy."

The researchers are calling for regulators to rapidly incorporate the findings into guidelines so that using the test to direct treatment with trifluridine/tipiracil becomes standard of care.

Professor Kristian Helin said, "Although chemotherapy can be very effective for many patients, it can also have debilitating side effects—and so it is important to have as much information as possible about how likely treatment is to work."

"This is an exciting advance for genomic medicine—showing that genomic tests are not just useful for guiding treatment with targeted therapies, but also harsher chemotherapies. It will have a big impact for people with advanced bowel cancer, by taking the guesswork out of their treatment."

[ConservativeMind]

The details are in the paper, which is free to read.

KRAS codon G12 (KRASG12) mutations are what were identified, and the test already exists, as does the therapy.

[ConservativeMind]

The “Take Charge Of Your Health” Ping List
This high volume ping list is for health articles and studies which describe something you or your doctor, when informed, may be able to immediately implement for your benefit.

Email me to get on either the “Common/Top Issues” (20 - 25% fewer pings) or “Everything” list.

[Reddy]

The sceptic in me immediately screams “rationing”.

[Grampa Dave]

Genomic medicine—showing that genomic tests are not just useful for guiding treatment with targeted therapies, but who will do better or get worse.

We need similar tests re Covid severity or an excellent response to treatment or a poor response.

One of the Covid mysteries, we have seen, is healthy men getting hit hard by one of the Covid Variants. Yet, their wives and kids don’t get Covid while living in the same house. Or they get a mild case for a few days and Dad is miserable for a week or more.