Jan 22, 2021 03:12AM BevJen wrote:
I am eligible for keytruda because I have what's known as tumor mutation burden high. The FDA has approved the use of keytruda as a single agent across all solid cancer types for TMB-High and also for something known as micro satellite instability high.
These mutation "markers" (not sure if that's the right word) must be demonstrated via one of the approved genomic tests, based upon a tumor biopsy. Think Foundation One (mentioned here before). I've had two different genomic tests -- Foundation One and Tempus -- as well as a liquid F1 biopsy. I'm seen at a major cancer center. You say that you've had a "genetic" test -- those will only show inherited BC genes, not things that may have developed during your cancer (known as somatic mutations). I've had genetic testing done in the past, too -- and it basically showed nothing. But my cancer has clearly mutated while I've had it, and that's what these genomic tests show.
I would discuss the possibility of a surgical biopsy with your MO to see what else could be used. Also, I've seen that some people move from Ibrance to Verzenio (there are several people on the boards who have done that) and Verzenio, which is taken every day, has help them some.
Also, you may want to consider a second opinion on your whole situation. If you cannot travel to a major cancer center (not sure where you live) you can try to arrange such a consult via Telehealth. It would require gathering all of your scans (when you have your PET, ask for a disk as well as the report -- you will need both for a second opinion) and making contact in advance to try and set this up.