Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, R&D, Baltimore.
Champions Oncology, R&D, Baltimore, USA.
Ann Oncol. 2017 Oct 1;28(10):2595-2605. doi: 10.1093/annonc/mdx416.
While patient-derived xenografts (PDXs) offer a powerful modality for translational cancer research, a precise evaluation of how accurately patient responses correlate with matching PDXs in a large, heterogeneous population is needed for assessing the utility of this platform for preclinical drug-testing and personalized patient cancer treatment.
Tumors obtained from surgical or biopsy procedures from 237 cancer patients with a variety of solid tumors were implanted into immunodeficient mice and whole-exome sequencing was carried out. For 92 patients, responses to anticancer therapies were compared with that of their corresponding PDX models.
We compared whole-exome sequencing of 237 PDX models with equivalent information in The Cancer Genome Atlas database, demonstrating that tumorgrafts faithfully conserve genetic patterns of the primary tumors. We next screened PDXs established for 92 patients with various solid cancers against the same 129 treatments that were administered clinically and correlated patient outcomes with the responses in corresponding models. Our analysis demonstrates that PDXs accurately replicate patients' clinical outcomes, even as patients undergo several additional cycles of therapy over time, indicating the capacity of these models to correctly guide an oncologist to treatments that are most likely to be of clinical benefit.
Integration of PDX models as a preclinical platform for assessment of drug efficacy may allow a higher success-rate in critical end points of clinical benefit.
虽然患者来源的异种移植物(PDX)为癌症转化研究提供了一种强大的方法,但为了评估该平台在临床前药物测试和个性化患者癌症治疗中的效用,需要对大量异质人群中患者反应与匹配 PDX 之间的相关性进行精确评估。
对 237 名患有各种实体瘤的癌症患者的手术或活检过程中获得的肿瘤进行植入免疫缺陷小鼠,并进行全外显子组测序。对于 92 名患者,比较了他们的抗癌治疗反应与其相应 PDX 模型的反应。
我们比较了 237 个 PDX 模型的全外显子组测序结果与癌症基因组图谱数据库中的等效信息,证明了肿瘤移植物忠实地保留了原发性肿瘤的遗传模式。接下来,我们对 92 名患有各种实体癌的患者建立的 PDX 进行了筛选,以对抗临床上使用的 129 种相同的治疗方法,并将患者的结果与相应模型的反应进行了相关性分析。我们的分析表明,PDX 能够准确复制患者的临床结果,即使患者随着时间的推移经历了几次额外的治疗周期,这表明这些模型有能力正确指导肿瘤学家选择最有可能具有临床获益的治疗方法。
将 PDX 模型整合为评估药物疗效的临床前平台,可能会提高临床获益的关键终点的成功率。