Had a tissue biopsy over a year ago and it was semi successful

I meant to say, I am getting a lot of feedback as to the pros and cons of having a second tissue biopsy. Sorry for the confusion.

I'm tagging a few knowledgeable members to join this discussion like @stageivsurvivor @ncteacher @markymarkfl @gamaryanne @thebobk among others, who may be able to provide feedback.

In the meantime @wheatley, can you share more about the pros and cons of having a second tissue biopsy that you've received from your medical team?

We are considering an updated genetics test since they seem to be finding more genes to test. My doctor recommended this.

Not sure if that is same as molecular test but I see in my hospital notes as ample was sent for this.

The question of repeating a tissue biopsy test was brought up this past Saturday by someone participating in the Columbia Presbyterian Pancreas Center Pancreas Awareness day program. As a patient advocate on a few GI Cancers Committees of different organizations, I have also inquired over the years since I first had genetic testing done in 2013 of a limited gene panel that found my gene mutation. In my situation because it was initially a limited panel focusing on a few specific genes, the response from my geneticist was to do testing to see if any other mutations could be found. Next Generation Sequencing (NGS) of a greatly expanded panel done four years after initial testing found no other mutations of known pathogenicity.

Also, since my initial testing, gene fusion products were discovered and their functions elucidated and found that some are targetable with specific treatments. An example is the rare somatic mutation type NTRK 1, 2, or 3 genes forming a chromosomal rearrangement with one of many different genes. It is found across several different cancers including pancreatic. RET fusion mutations are another example. So one should review the prior molecular profiling (NGS) results to see if the test panel at that time included gene fusions such as NTRK and RET.

At the most recent Fall meeting of the Eastern Comprehensive Oncology Group-Acadamy of Clinical Radiology and Imaging (ECOG-ACRIN) where I am a Patient Advocate on the GI cancers committee (11 year survivor stage IV pancreatic cancer and a 40+ year career in clinical cancer and immunology research), I polled a few oncologists on the committee about the recommendations on frequency of repeating genetic testing to take advantage of new discoveries. New discoveries are not frequent and I learned that no professional group such as the American a Society of Clinical Oncology (ASCO) or the National Comprehensive Cancer Network (NCCN) has published recommendations yet on frequency of repeating the test.