TP53 +KEAP1 lung cancer stage 4
My indian mom (52F) has stage 4 lung adenocarcinoma. The cancer started in her lungs and has spread to her spine/vertebrae and bones. She’s currently struggling a lot with breathing issues, mucus buildup, weakness, and low stamina.
Recent chest X-rays show a large abnormal area/mass in the right lung along with patchy lower lung changes. She often needs to sit leaning forward because it helps her breathe and clear mucus better.
We recently got her liquid biopsy/molecular testing results back. Mutations found include:
\- TP53 (M133T and D41Vfs\*3)
\- ATM C728\*
\- KEAP1 Y584\*
\- RAF1 N262K
\- CTNNB1 S33C
TMB was elevated at 17.08 mut/Mb.
The report said there are no standard FDA-approved targeted therapies for the TP53 mutations specifically. From what I understand, the elevated TMB may mean immunotherapy could still help, but the KEAP1 mutation may make the cancer more aggressive or resistant.
She does NOT appear to have EGFR/ALK/ROS1-type mutations.
We are trying to figure out:
\- Best treatment options at this stage
\- Experiences with immunotherapy in TP53 + KEAP1 lung cancer
\- Whether ATM mutation opens any meaningful options
\- Whether anyone has had success with clinical trials for TP53 mutations
\- Best hospitals/doctors internationally or in India for advanced lung adenocarcinoma cases like this
\- How to improve performance status/strength enough to tolerate treatment better
Most important thing for us right now is maximizing both survival and quality of life.
If anyone has dealt with a similar mutation profile or advanced lung adenocarcinoma case, I’d really appreciate hearing what helped, what didn’t, and what questions we should be asking the oncologists.