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难治性癌症治疗中的肿瘤分子谱分析

Tumor molecular profiling in the treatment of refractory cancers.

作者信息

Birendra K C, Afzal Muhammad Zubair, Sochaki Andrew, Wentland Katherine A, Chang Rubens, Singh Sudhir, O'Rourke Timothy

出版信息

J Exp Ther Oncol. 2015;11(1):27-32.

Abstract

INTRODUCTION

Molecular profiling (MP) has been used as a technique to identify treatment regimens for individual patient's cancer. The results of MP has been used to guide targeted therapy specific to each patient's tumor that resulted in a longer progression free survival (PFS) compared to the last conventional treatment. This study aims to provide further data to delineate the PFS of patients who get treated with targeted therapy based on MP.

METHODS

A retrospective chart review was performed. The patients were greater than 18 years of age refractory to at least one standard treatment and enrolled in the study: "A Clinical Data Registry Study of Patients with Advanced Refractory Cancers Electing OncInsights as a Method to Support Physician Choice of Drug Therapy". The location is a West Michigan Hematology-Oncology private practice during the period of 07/2010-02/2013. We considered the molecular profiled treatment regimen a success if the PFS ratio was ≥ 1.3.

RESULTS

18 patients were included in the study. 55% were male and 45% were female with median age of 57.67 +/- 12.02 at the time of diagnosis. 4/18 (22%) patients achieved a PFS ratio >1.3. The patients with a PFS ratio ≥ 1.3 included GIST (imatinib- > sunitinib); angiosarcoma (docetaxel- > sorafenib, pravastatin); thymoma (paclitaxel- > desatinib); and angiosarcoma (gemcitabine- > sunitinib).

CONCLUSION

This study demonstrates the potential value of molecular profiling in patients refractory to prior chemotherapeutic agents in a community setting. Continued work on rapid implementation of molecular profiling earlier in the care of oncology patients continues to be a future goal.

摘要

引言

分子图谱分析(MP)已被用作一种为个体癌症患者确定治疗方案的技术。MP的结果已被用于指导针对每位患者肿瘤的靶向治疗,与上一次传统治疗相比,该治疗可带来更长的无进展生存期(PFS)。本研究旨在提供更多数据,以描绘接受基于MP的靶向治疗患者的PFS情况。

方法

进行了一项回顾性病历审查。患者年龄大于18岁,对至少一种标准治疗无效,并入选了“一项将OncInsights作为支持医生选择药物治疗方法的晚期难治性癌症患者临床数据登记研究”。研究地点为2010年7月至2013年2月期间密歇根州西部的一家血液肿瘤私人诊所。如果PFS比值≥1.3,我们认为分子图谱分析治疗方案是成功的。

结果

18名患者纳入研究。55%为男性,45%为女性,诊断时的中位年龄为57.67±12.02岁。4/18(22%)的患者PFS比值>1.3。PFS比值≥1.3的患者包括胃肠道间质瘤(伊马替尼>舒尼替尼);血管肉瘤(多西他赛>索拉非尼、普伐他汀);胸腺瘤(紫杉醇>达沙替尼);以及血管肉瘤(吉西他滨>舒尼替尼)。

结论

本研究证明了分子图谱分析在社区环境中对先前化疗药物难治的患者中的潜在价值。在肿瘤患者护理中更早地快速实施分子图谱分析的持续工作仍是未来的目标。

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