Squamous cell lung cancer and mutation testing

I've been told that there are no targeted therapies for squamous cell lung cancer. Do oncologists therefore not test for mutations if it has been diagnosed as squamous cell? That is what my moms doctor told us. I would think they would test anyway in case something comes up. Originally they told us they did test for mutations. And last week when I asked what mutations they tested for they said no, they did not test because she was diagnosed with squamous cell. Is that normal protocol to not test for mutations if it is squamous cell? I'm tempted to have them test anyway.

I've found some interesting links that I will be printing out and showing my moms oncologist on Thursday when I take her in for her first chemo session.

http://www.ascopost.com/issues/april-15,-2013/genomic-analysis-of-squamous- cell-lung-cancer-tumors-may-lead-to-more-targeted-therapies.aspx

http://www.mskcc.org/blog/testing-mutations-identified-squamous-cell-lung-t umors-helps-personalize-treatment

Libby

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I was diagnosed with squamous cell nsclc over six years ago and tested positive for the egfr gene and was put on tarceva for over 2 1/2 years.I have been ned since that time.

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My husband has stage 3b squamous, he has been treated with radiation concurrently with 2 rounds of chemotherapy. I have asked for mutation testing and been turned down, I have asked for an outside opinion for him at the Knight Institute thru OHSU. They have turned me down twice. Our oncologist is leaving KP in a few weeks and we are being turned over to a new Oncologist. i am glad of that actually. Unfortunately I am not a happy wife right now and could easily let my choctaw blood kick and have a royal WAR DANCE here if I don't get some attention.
I want Ron the have the damn chemo! He has a new thickened lump under the R nipple, the Onc when reported to today, said have his primary care see him. This really set me off I must say. So forgive me for spouting off on your parade and I sure do appreciate these articles and i will be talking about mutations as I have before.
Bless us all!

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There was a discussion on another thread about not mutation testing if you have SCLC either. You wouldn't normally think of giving Tarceva for SCLC and you wouldn't think of giving Tarceva for squamous cell lung cancer either. However, there is anti-angiogenic activity and VEGF pathway inhibition of Tarceva.

http://cancerfocus.org/forum/showthread.php?t=3738

Greg

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In one of the many cancer slideshows, presentations I have read I recall that EGFR+ is in 3% of squamous cell cancers and this presentation said it wasn't worth testing for!

I would strongly disagree!

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There is mutation testing for squamous cell. My father had it done at Sloan Kettering with via Dr. Paik who is the doctor in one of the links you posted. Dad has one of the mutations, FGFR1 amplification and there is a trial for a targeted therapy.

Insist on the testing and if the facility can't do it, tell them to refer you to a place that does it.

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I noted this on another thread, but I'll also note it here as well (it applies).

While genomics focuses on how genes direct activities within the cell, proteomics studies how proteins carry out those directions. Genes create the blueprints for the production of proteins within the cell. A protein is a molecule that makes a cell behave in a certain way. It does so by interacting with other proteins in a complex series of steps.

However, in chemotherapy selection, gene and protein testing examine a single process within the cell or a relatively small number of processes. The aim is to tell if there is a theoretical predisposition to drug response. Cell function analysis tests not only for the presence of genes and proteins but also for their functionality, for their interaction with other genes, proteins and processes occurring within the cell, and for their response to anti-cancer drugs.

Genomics is only important insofar as it influences proteonomics, which is only important insofar as it influences protein function analysis (are proteins active or inactive), which is only important insofar as it influences cell function analysis. There is an inverse hierachy between relevance and ease of measurement. So genomics and proteonomics are not the only potential key to genetic disease.

Greg

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There are mutations, targeted therapies and clinical trials for squamous patients. I know because I am one of them. I have had all mutation tests particularly for squamous (fGFR1, DDR2, etc) and also others ALK. EFGR etc done. I don't have any mutations unfortunately.
I am currently in a PD-1 clinical trial for squamous patients.
There aren't as many options as for adeno carcinoma but there are some and more are becoming available.
Request a second opinion for your Mom at a major cancer center.
Good luck!
Darby

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I have squamous and my med onc sent my specimen for mutation testing right away. It's definitely available!

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I agree and thank all of those who have given such alot of input. it all helps when we get in front of that doc and are told no this is not indicated or only 2.7% have the mutation. I have made appointments and am looking forward to Ron being seen tomorrow and my questions being answered or explain a rationale for what ever the next treatment plan is. We need answers and a treatment plan.

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Thanks Davstar,
These people are getting on my last nerve. I am getting so disgusted with his Onc and am glad there is another coming soon. I want some help getting a referral for Ron, I want some mutations testing done and to have a real partner in the treatment decisions and not being dictated to. Thank Goodness we will get some income soon to be able to afford to pay out of pocket for a lung cancer specialist opinion. We been on one income the past 6 months. it's hard.

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Well, wish us luck today....I have lots of ammo now.

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Davstar,
You are right about that it is a sad state of affairs for sure. I can be a real bulldog and hate to get in that mode but it's coming! I am going to really make a point I want a lung cancer specialist. When I called to make an appt yesterday with the supposed new onc, I was told oh he is not here another 2-3 weeks and we need to have you see his current onc. She then said he does not need seen until Nov? I said oh hell no! I want an appt right away, he is supposed to have more chemo or i want to know the reason why not. CRAP!!!

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