🏥 Lucy L. from Boston, MA: I am an oncology nurse at Dana Farber. Your section about Lumakras, a KRAS-inhibiting medication, was portrayed inaccurately. Not once did you mention that this is only for lung cancer. KRAS is a genetic biomarker for lung cancer only. 

We already know that immunotherapy works well for lung cancer patients. That's why most lung cancer patients are surviving longer these days. Immunotherapy is far more expensive and there are also side effects just like chemotherapy even though it is "just a pill or transfusion". 

Unfortunately, chemo is not replaced if it has spread to lymph nodes or other areas in the body. KRAS is not a biomarker for other solid tumors such as breast, prostate, bladder, brain, kidney, liver, sarcoma, colon, pancreas, etc. We use biomarkers for many solid tumors and they are all unique. For example, biomarkers for breast are the hormones Estrogen (ER), Progesteron (PR), and Her2neu gene. 

When these are positive they are treated with an estrogen/progesterone inhibitor like Tamoxifen and herceptin treats Her2neu positive. So breast patient's who are ER/PR(+) don't require chemotherapy and only need radiation and hormone therapy. Triple negative breast patients require chemotherapy because they do not have markers to target.

🍩 The DONUT: *Asks for clarification*

🏥 Lucy L.: It's mainly for patient's who have the KRAS biomarkers. Description in the DONUT summary is portraying a level of inaccuracy by creating a context that chemotherapy may no longer be required because this one immunotherapy drug can treat all cancers. KRAS biomarkers are only in a limited patient population and mainly lung cancers. 

Not all lung cancers have KRAS biomarkers either. There's a variety of different pathologies that are treated differently. Each patient is treated based on their unique pathology and biomarkers. Colorectal cancers are still chemotherapy managed and this drug is added for this particular trial at MGH in the link you provided above. This would not be used for breast, prostate, kidney, etc. I have head and neck patients with HPV positive biomarkers and some with no biomarkers at all to target. 

This can be misleading to patients when worded the way the DONUT had worded it. It is discouraging for patient's who do not have any biomarkers in their pathology and do not qualify for targeted therapy to see a headline that they can take a pill and not require chemotherapy. So many patient's come to us confused with increased anxiety because their treatment is different from a friend or relative or from what they read online.