NRAS mutant gener
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NRAS mutant gener

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  • Post
    • March 11, 2014 at 1:59 pm
    DUSTILANE
    Participant

    My husband has metastisized melanoma.  They tested him for the BRAF gene, but he was negative for that.  However, he was positive for the NRAS gene.

     

    Does anyone have any information about that gene?

Viewing 14 reply threads
  • Replies
      • March 11, 2014 at 3:09 pm
      Tim–MRF
      Guest

      About 20% of melanomas have an NRAS mutation. Strategies for targeting that gene are not as far along as are strategies for the BRAF mutation.  Some trials for NRAS mutations are now beginning to open, however, so some options should be available.  You can use the MRF's clinical trials finder to look for trials, or call the toll-free number associated with that program and ask for some help.  

      You can also go to clinicaltrials.gov and search for NRAS and melanoma.  You will find three or four trials open, each with a different strategy.  The basic approach is to use a MEK inhibitor, or a MEK inhibitor in combination with another inhibitor–either CDK or AKT.  I know this sounds like alphabet soup, but the basic concept is this.  Researchers have not found a way to block NRAS, so they are trying to block other steps before or after activation of NRAS.

      In evaluating any trial, you should look carefully at the control arm and be sure it reflects good standard of care. Or, if not, the trial design should allow for crossover. This means that if you are on one arm of the trial and don't respond you can switch to the other arm of the trial.

       

      Tim–MRF

       

       

      • March 11, 2014 at 3:09 pm
      Tim–MRF
      Guest

      About 20% of melanomas have an NRAS mutation. Strategies for targeting that gene are not as far along as are strategies for the BRAF mutation.  Some trials for NRAS mutations are now beginning to open, however, so some options should be available.  You can use the MRF's clinical trials finder to look for trials, or call the toll-free number associated with that program and ask for some help.  

      You can also go to clinicaltrials.gov and search for NRAS and melanoma.  You will find three or four trials open, each with a different strategy.  The basic approach is to use a MEK inhibitor, or a MEK inhibitor in combination with another inhibitor–either CDK or AKT.  I know this sounds like alphabet soup, but the basic concept is this.  Researchers have not found a way to block NRAS, so they are trying to block other steps before or after activation of NRAS.

      In evaluating any trial, you should look carefully at the control arm and be sure it reflects good standard of care. Or, if not, the trial design should allow for crossover. This means that if you are on one arm of the trial and don't respond you can switch to the other arm of the trial.

       

      Tim–MRF

       

       

      • March 11, 2014 at 3:09 pm
      Tim–MRF
      Guest

      About 20% of melanomas have an NRAS mutation. Strategies for targeting that gene are not as far along as are strategies for the BRAF mutation.  Some trials for NRAS mutations are now beginning to open, however, so some options should be available.  You can use the MRF's clinical trials finder to look for trials, or call the toll-free number associated with that program and ask for some help.  

      You can also go to clinicaltrials.gov and search for NRAS and melanoma.  You will find three or four trials open, each with a different strategy.  The basic approach is to use a MEK inhibitor, or a MEK inhibitor in combination with another inhibitor–either CDK or AKT.  I know this sounds like alphabet soup, but the basic concept is this.  Researchers have not found a way to block NRAS, so they are trying to block other steps before or after activation of NRAS.

      In evaluating any trial, you should look carefully at the control arm and be sure it reflects good standard of care. Or, if not, the trial design should allow for crossover. This means that if you are on one arm of the trial and don't respond you can switch to the other arm of the trial.

       

      Tim–MRF

       

       

        • March 11, 2014 at 3:38 pm
        joy_
        Participant

        Tim,

        Would this mean that a person who is both BRAF and NRAS positive would benefit more from the combination of mekinist and tafinlar than someone who is one or the other?

        My husband is starting tx today for LMD but he also has body tumors to deal with. Doctor plans to start him on Tafinlar but hasn't decided about Mekinist.  I am glad to see this post because it gives uus something else to think about!

        Thanks!

         

        • March 11, 2014 at 3:38 pm
        joy_
        Participant

        Tim,

        Would this mean that a person who is both BRAF and NRAS positive would benefit more from the combination of mekinist and tafinlar than someone who is one or the other?

        My husband is starting tx today for LMD but he also has body tumors to deal with. Doctor plans to start him on Tafinlar but hasn't decided about Mekinist.  I am glad to see this post because it gives uus something else to think about!

        Thanks!

         

        • March 11, 2014 at 3:38 pm
        joy_
        Participant

        Tim,

        Would this mean that a person who is both BRAF and NRAS positive would benefit more from the combination of mekinist and tafinlar than someone who is one or the other?

        My husband is starting tx today for LMD but he also has body tumors to deal with. Doctor plans to start him on Tafinlar but hasn't decided about Mekinist.  I am glad to see this post because it gives uus something else to think about!

        Thanks!

         

      • March 11, 2014 at 4:19 pm
      eric w
      Participant

      May want to look at this as well.

       

      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3241890/

      • March 11, 2014 at 4:19 pm
      eric w
      Participant

      May want to look at this as well.

       

      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3241890/

      • March 11, 2014 at 4:19 pm
      eric w
      Participant

      May want to look at this as well.

       

      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3241890/

      • March 12, 2014 at 2:36 am
      BrianP
      Participant

      Toward the bottom of this thread there is some interesting information for new treatments/trials for NRAS/Braf (-) patients.

      http://forum.melanomainternational.org/mif/viewtopic.php?f=54&t=34877

      Brian

      • March 12, 2014 at 2:36 am
      BrianP
      Participant

      Toward the bottom of this thread there is some interesting information for new treatments/trials for NRAS/Braf (-) patients.

      http://forum.melanomainternational.org/mif/viewtopic.php?f=54&t=34877

      Brian

      • March 12, 2014 at 2:36 am
      BrianP
      Participant

      Toward the bottom of this thread there is some interesting information for new treatments/trials for NRAS/Braf (-) patients.

      http://forum.melanomainternational.org/mif/viewtopic.php?f=54&t=34877

      Brian

      • March 12, 2014 at 3:23 pm
      DUSTILANE
      Participant

      My husband cannot do one of the treatments listed in that article due to bad heart condition. He is doing the IPI treatment.  He has taken 2 treatments so far.  The next one is due 03/25/14

       

      • March 12, 2014 at 3:23 pm
      DUSTILANE
      Participant

      My husband cannot do one of the treatments listed in that article due to bad heart condition. He is doing the IPI treatment.  He has taken 2 treatments so far.  The next one is due 03/25/14

       

      • March 12, 2014 at 3:23 pm
      DUSTILANE
      Participant

      My husband cannot do one of the treatments listed in that article due to bad heart condition. He is doing the IPI treatment.  He has taken 2 treatments so far.  The next one is due 03/25/14

       

        • March 13, 2014 at 4:41 am
        odonoghue80
        Participant

        I saw the article about NRAS gene bad responding better to IL-2. Is there any more information about this? Any studies with IL-2 for BRAF positive people? Just curious. I've brought this gene markers for IL-2 but they haven't been inclined to speak of it.

        Thanks,

        Shane  

        • March 13, 2014 at 4:41 am
        odonoghue80
        Participant

        I saw the article about NRAS gene bad responding better to IL-2. Is there any more information about this? Any studies with IL-2 for BRAF positive people? Just curious. I've brought this gene markers for IL-2 but they haven't been inclined to speak of it.

        Thanks,

        Shane  

        • March 13, 2014 at 4:41 am
        odonoghue80
        Participant

        I saw the article about NRAS gene bad responding better to IL-2. Is there any more information about this? Any studies with IL-2 for BRAF positive people? Just curious. I've brought this gene markers for IL-2 but they haven't been inclined to speak of it.

        Thanks,

        Shane  

      • March 15, 2014 at 3:55 am
      JerryfromFauq
      Participant

      IL-2 is the only approved Treatment that has been shown to have a high response rate against NRAS melanomas.  I have not seen any  data as to how effective the other the other immunotherapies are supposed to be against the NRAS.  As Tim mentioned, they have not developed a targeted treatment to interrupt the ssignaling path for the NRAS.

       

      • March 15, 2014 at 3:55 am
      JerryfromFauq
      Participant

      IL-2 is the only approved Treatment that has been shown to have a high response rate against NRAS melanomas.  I have not seen any  data as to how effective the other the other immunotherapies are supposed to be against the NRAS.  As Tim mentioned, they have not developed a targeted treatment to interrupt the ssignaling path for the NRAS.

       

      • March 15, 2014 at 3:55 am
      JerryfromFauq
      Participant

      IL-2 is the only approved Treatment that has been shown to have a high response rate against NRAS melanomas.  I have not seen any  data as to how effective the other the other immunotherapies are supposed to be against the NRAS.  As Tim mentioned, they have not developed a targeted treatment to interrupt the ssignaling path for the NRAS.

       

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