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比较基于肿瘤分子图谱的靶向治疗与传统治疗对难治性癌症患者疗效的随机概念验证II期试验:SHIVA试验可行性部分的结果

Randomised proof-of-concept phase II trial comparing targeted therapy based on tumour molecular profiling vs conventional therapy in patients with refractory cancer: results of the feasibility part of the SHIVA trial.

作者信息

Le Tourneau C, Paoletti X, Servant N, Bièche I, Gentien D, Rio Frio T, Vincent-Salomon A, Servois V, Romejon J, Mariani O, Bernard V, Huppe P, Pierron G, Mulot F, Callens C, Wong J, Mauborgne C, Rouleau E, Reyes C, Henry E, Leroy Q, Gestraud P, La Rosa P, Escalup L, Mitry E, Trédan O, Delord J-P, Campone M, Goncalves A, Isambert N, Gavoille C, Kamal M

机构信息

1] Institut Curie, Paris, France [2] Unité INSERM/Institut Curie U900, Paris, France [3] Institut Curie, Saint-Cloud, France.

1] Institut Curie, Paris, France [2] Unité INSERM/Institut Curie U900, Paris, France.

出版信息

Br J Cancer. 2014 Jul 8;111(1):17-24. doi: 10.1038/bjc.2014.211. Epub 2014 Apr 24.

Abstract

BACKGROUND

The SHIVA trial is a multicentric randomised proof-of-concept phase II trial comparing molecularly targeted therapy based on tumour molecular profiling vs conventional therapy in patients with any type of refractory cancer. RESULTS of the feasibility study on the first 100 enrolled patients are presented.

METHODS

Adult patients with any type of metastatic cancer who failed standard therapy were eligible for the study. The molecular profile was performed on a mandatory biopsy, and included mutations and gene copy number alteration analyses using high-throughput technologies, as well as the determination of oestrogen, progesterone, and androgen receptors by immunohistochemistry (IHC).

RESULTS

Biopsy was safely performed in 95 of the first 100 included patients. Median time between the biopsy and the therapeutic decision taken during a weekly molecular biology board was 26 days. Mutations, gene copy number alterations, and IHC analyses were successful in 63 (66%), 65 (68%), and 87 (92%) patients, respectively. A druggable molecular abnormality was present in 38 patients (40%).

CONCLUSIONS

The establishment of a comprehensive tumour molecular profile was safe, feasible, and compatible with clinical practice in refractory cancer patients.

摘要

背景

SHIVA试验是一项多中心随机概念验证II期试验,比较基于肿瘤分子谱分析的分子靶向治疗与传统治疗在任何类型难治性癌症患者中的疗效。本文展示了对首批入组的100例患者进行可行性研究的结果。

方法

符合标准治疗失败的任何类型转移性癌症的成年患者均符合本研究条件。通过强制活检进行分子谱分析,包括使用高通量技术进行突变和基因拷贝数改变分析,以及通过免疫组织化学(IHC)测定雌激素、孕激素和雄激素受体。

结果

在首批入组的100例患者中,95例患者安全地完成了活检。活检与每周分子生物学会议期间做出治疗决策之间的中位时间为26天。突变、基因拷贝数改变和IHC分析分别在63例(66%)、65例(68%)和87例(92%)患者中成功完成。38例患者(40%)存在可靶向治疗的分子异常。

结论

建立全面的肿瘤分子谱在难治性癌症患者中是安全、可行的,并且与临床实践相兼容。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/35d3/4090722/7f6ccda19dbe/bjc2014211f1.jpg

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