Zimmer Kai, Kocher Florian, Spizzo Gilbert, Salem Mohamed, Gastl Guenther, Seeber Andreas
Department of Haematology and Oncology, Medical University of Innsbruck, Austria.
Levine Cancer Institute, Carolinas HealthCare System, Charlotte, USA.
Comput Struct Biotechnol J. 2019 Mar 26;17:447-453. doi: 10.1016/j.csbj.2019.03.012. eCollection 2019.
In this review we aim to summarize studies investigating the impact of a molecular profiling (MP)-guided treatment approach in heavily pretreated cancer patients. In summary, many independent single- and multicenter studies showed a significant benefit of MP-guided treatment regarding response rates and survival. However, in the only randomized trial conducted so far, no benefit of MP-guided targeted therapy was observed. Notably, various profiling approaches were conducted in the respective studies: some studies used a single analytic approach (i.e. next-generation sequencing), others applied multiple analytic methods to perform comprehensive molecular profiling. It seems that multiplatform profiling analyses, detected an increased number of druggable molecular targets or signaling pathway alterations and that a higher proportion of patients was treated according to the molecular cancer profile. Even though no randomized study has shown a benefit of molecular profiling so far, many studies indicate that MP-guided treatment can be beneficial in patients with relapsed and/or refractory cancer. Currently ongoing large randomized trials (i.e. NCI-MATCH, TAPUR) will add evidence to the role of profiling-guided cancer treatment.
在本综述中，我们旨在总结有关分子谱分析（MP）指导的治疗方法对经过大量预处理的癌症患者影响的研究。总的来说，许多独立的单中心和多中心研究表明，MP指导的治疗在缓解率和生存率方面具有显著益处。然而，在迄今为止进行的唯一一项随机试验中，未观察到MP指导的靶向治疗有任何益处。值得注意的是，各研究采用了不同的谱分析方法：一些研究使用单一分析方法（即下一代测序），另一些研究则应用多种分析方法进行全面的分子谱分析。似乎多平台谱分析检测到了更多可成药的分子靶点或信号通路改变，并且更高比例的患者根据分子癌症谱接受了治疗。尽管目前尚无随机研究表明分子谱分析有益，但许多研究表明，MP指导的治疗对复发和/或难治性癌症患者可能有益。目前正在进行的大型随机试验（即NCI-MATCH、TAPUR）将为谱分析指导的癌症治疗作用提供更多证据。
