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Colon Cancer and Genetic Testing
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Dr. John Marshall explains why genetic testing of colon cancer cells is necessary to determine what variant of colon cancer you have, and how testing will ultimately define the best treatment plan for you as a patient. Mutations of the RAS, HER-2, and BRAF genes require different approaches to treat. Microsatellite instability (MSI) and what side your tumor is on are also important factors that can change what medications your doctor adds or removes from a regimen.
Transcript:
With colon cancer, we now know that not all of them are the same. And so, your doctor probably has already ordered some gene tests on your cancer. These are very, very important because they're teaching us about what medicines to use in what setting. And these are not gene tests on your normal cells, these are gene tests on your cancer cells. And so, usually this has been sent to some pathology lab, either at your hospital or someplace further. And there are key genes that you must know for your cancers.
So one, you need to know something called RAS, R-A-S. And there's a bunch of RASes, there's KRAS, and HRAS, and NRAS, and you need to know them all to know whether your tumor has a mutation in those or not. That matters.
Secondly, you need to know something called MSI, microsatellite instability. And everyone's really aware of this because those patients, although rare, who are MSI-high, are the ones that respond much better to the new immune therapies.
You also need to know something called HER-2. This is actually a breast cancer marker, but it turns out that some patients with colon cancer have a broken HER-2 gene in their tumor, and some of the breast cancer drugs are working for colon cancer.
And then, in sort of a weird way, you need to know what side your cancer was on because certain drugs will work on the left side that don't work on the right side. So, where that primary tumor was, for unclear reason, dictates which drugs will work when.
And the last one that you need to know is something called BRAF, B-R-A-F. And that matters because nine percent or so of colon cancer patients have this mutation, and there are some new treatment strategies for that group of patients.
So, know your tumor, know all of those, write them down. You will be a better patient, you'll get better outcomes.
Transcript:
With colon cancer, we now know that not all of them are the same. And so, your doctor probably has already ordered some gene tests on your cancer. These are very, very important because they're teaching us about what medicines to use in what setting. And these are not gene tests on your normal cells, these are gene tests on your cancer cells. And so, usually this has been sent to some pathology lab, either at your hospital or someplace further. And there are key genes that you must know for your cancers.
So one, you need to know something called RAS, R-A-S. And there's a bunch of RASes, there's KRAS, and HRAS, and NRAS, and you need to know them all to know whether your tumor has a mutation in those or not. That matters.
Secondly, you need to know something called MSI, microsatellite instability. And everyone's really aware of this because those patients, although rare, who are MSI-high, are the ones that respond much better to the new immune therapies.
You also need to know something called HER-2. This is actually a breast cancer marker, but it turns out that some patients with colon cancer have a broken HER-2 gene in their tumor, and some of the breast cancer drugs are working for colon cancer.
And then, in sort of a weird way, you need to know what side your cancer was on because certain drugs will work on the left side that don't work on the right side. So, where that primary tumor was, for unclear reason, dictates which drugs will work when.
And the last one that you need to know is something called BRAF, B-R-A-F. And that matters because nine percent or so of colon cancer patients have this mutation, and there are some new treatment strategies for that group of patients.
So, know your tumor, know all of those, write them down. You will be a better patient, you'll get better outcomes.
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