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Dec 13, 2018 11:58AM
Dec 13, 2018 11:59AM
Interesting question! I am also so encouraged by SandiLee's success, esp as we share a similar cancer subtype (Er+PR-), so hope I can be like you! It seems you started on just Faslodex alone? My question is can you get Foundation One sequencing and testing if the progression remains only in bones, or do you have to wait for tissue mets? Or are there circulating tumor cell assays available now? And with bone progression, can they radiate or do they have to move to the next treatment. My oncologist has indicated that she just moves to Faslodex alone for secondline, but the trials indicate a PFS of only about six months, so its not surprising, Dorimak, that you progressed so fast. And for SandiLee, the second try of faslodex was with a CDK4,6 inhibitor and it came after some chemo, so the cancer was exposed to different things that allowed the estrogen-dependence to re-emerge. This is why it is so helpful to be able to see the different sequence of treatments. So, SandiLee, you are about 71/2 years since diagnosis and have been on Abemaciclib and Faslodex for the past six months?! That is very heartening, that the side effects must be so much less than on chemo and you can be on such a treatment when you are years from diagnosis. Plus there are other treatments you have not tried yet, like the Alpelisib, and somehow you avoided the Aromasin-Affinitor? (good job!!), a CDK12 inhibitor, Venetoclax, and the others working their way into the system. Plus immunotherapy when they figure out a combo that works. Sandi, what does your oncologist say about how well you are doing? You must be his/her star patient!! Do you seek out a second opinion at every change?
From what I have read, estrogen resistance arises due to PI3K mutation about 40% of the time, and from ESR1 mutations about 27% of the time (or both are also common), and due to conversion to HER2-positive about 20% of the time, with triple-negative and triple-positive and other changes (FGFR) etc also possible but with lesser frequency. So it would be important to sequence to know why the cancer has progressed, especially wouldn't it be great to discover it mutated to HER2-positive and now you can take all of those other drugs?!
10/2003, IDC, Stage IIB, ER+/PR+, HER2-
7/2015, Stage IV, metastasized to bone, ER+/PR-, HER2-