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New biomarker Claudin 18.2

Pancreatic Cancer | Last Active: Mar 29 1:40pm | Replies (13)

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Good thinking and good planning on your part!

My CA19-9 is only down a few points since resuming full-dose GAC after two reduced doses and one missed dose, but at least that reversed the upward trend. New data coming in two weeks...

Interesting news in my mutation department: We've known all along about my germline ATM mutation. When docs finally sent my 1.5-year old Whipple tissue to Tempus last month, it reported the KRAS G12D mutation. But, we also just sent new blood to Guardant, which reported a CHEK2 mutation but nothing on KRAS (despite reporting that it checks for "amplifications of this gene.")

It makes me wonder if Whipple got all the tissue with KRAS mutations. You'd think if that were an advantageous mutation and Whipple didn't get it all, that my recurrence would be flooded with KRAS by now. On the other hand, it may simply be that the tissue test was significantly more sensitive than the blood test.

On the other hand, CHEK2 was not reported in my two previous Guardant blood tests, and that one seems to correlate somewhat with chemo resistance in the literature and with my imaging/CA19 relapse.

It leaves me confused as to whether the best clinical trial for me should target ATM, KRAS, or CHEK2.

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Replies to "Good thinking and good planning on your part! My CA19-9 is only down a few points..."

Hello @markymarkfl
I haven't heard of the CHEK2 mutation until now; at least it doesn't seem to be a triple threat for pancreatic cancer from what I've read, and that's fantastic! I would agree with you that a tissue test would be more sensitive than a blood test when testing for DNA sequences.
Also, from my readings it appears that the ATM accelerates the effect of the KRAS12-D gene. If you eliminate the KRAS12-D gene, I wonder if that makes the ATM gene somewhat ineffective? Once my GAC chemo stops working, hopefully there will be a KRAS12-D clinical still open for which I can register; my 2 oncology drs. haven't expressed any interest in providing me any type of radiation. I feel pretty good these days, even did my 2 mile walk again which I haven't done since last December, just sold our house for cash offer, and am busy preparing for phase 2 of my life; beginning my bucket list just in case those clinical trials don't coincide with my journey. I hope and pray that a cure is found soon! Good luck and please let us know of your progress!