Lu Hongyang, Xu Haimiao, Xie Fajun, Qin Jing, Han Na, Fan Yun, Mao Weimin
Zhejiang Cancer Hospital, Zhejiang Key Laboratory of Diagnosis & Treatment Technology on Thoracic Oncology (Lung and Esophagus), Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Thoracic Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China.
Department of Pathology, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China.
Onco Targets Ther. 2016 Jun 16;9:3571-7. doi: 10.2147/OTT.S108781. eCollection 2016.
The prognosis of small-cell lung cancer (SCLC) is poor despite reports suggesting modest improvement in survival. To date, chemotherapy remains the cornerstone treatment for SCLC patients, and many studies have focused on identifying the molecular characteristics of SCLC, which serve as the basis for precision treatments that improve the prognosis of SCLC. For instance, the therapeutic effect of temozolomide, recommended for patients with relapsed SCLC, is linked to 1p/19q codeletion in anaplastic oligodendroglial tumors. A subpopulation of SCLC patients may derive benefit from tyrosine kinase inhibitors targeting RET. In order to identify 1p/19q codeletion and RET rearrangement in SCLC patients, 32 SCLC resected specimens were retrospectively collected between 2008 and 2014 from the Zhejiang Cancer Hospital in People's Republic of China. Fluorescence in situ hybridization was used to detect 1p/19q codeletion and RET rearrangement in the specimens. A 1p single deletion was detected in eight specimens, 19q single deletion was detected in three specimens, and only three specimens had a 1p/19q codeletion. None of the specimens had a RET rearrangement. The three patients whose specimens had a 1p/19q codeletion were alive after 58, 50, and 30 months of follow-up care. There was a trend toward prolonged overall survival for the patients with codeletion compared to no codeletion, 1p single deletion, 19q single deletion, and without 1p and 19q deletion (P=0.113, 0.168, 0.116, and 0.122, respectively). Our data showed that RET rearrangement may be not an ideal molecular target for SCLC therapies in People's Republic of China. Instead, 1p/19q codeletion is a promising marker for a good prognosis and treatment with temozolomide in SCLC.
尽管有报告显示小细胞肺癌(SCLC)患者的生存率有适度提高,但其预后仍然很差。迄今为止,化疗仍然是SCLC患者的基石治疗方法,许多研究都集中在确定SCLC的分子特征上,这些特征是改善SCLC预后的精准治疗的基础。例如,推荐用于复发性SCLC患者的替莫唑胺的治疗效果与间变性少突胶质细胞瘤中的1p/19q共缺失有关。一部分SCLC患者可能从靶向RET的酪氨酸激酶抑制剂中获益。为了确定SCLC患者中的1p/19q共缺失和RET重排,2008年至2014年期间从中华人民共和国浙江省肿瘤医院回顾性收集了32例SCLC切除标本。采用荧光原位杂交技术检测标本中的1p/19q共缺失和RET重排。8例标本检测到1p单缺失,3例标本检测到19q单缺失,仅3例标本存在1p/19q共缺失。所有标本均未检测到RET重排。3例标本有1p/19q共缺失的患者在随访58、50和30个月后仍存活。与无共缺失、1p单缺失、19q单缺失以及无1p和19q缺失的患者相比,共缺失患者的总生存期有延长趋势(P值分别为0.113、0.168、0.116和0.122)。我们的数据表明,RET重排在中华人民共和国可能不是SCLC治疗的理想分子靶点。相反,1p/19q共缺失是SCLC预后良好和使用替莫唑胺治疗的一个有前景的标志物。