基于靶向基因panel 的肿瘤突变负荷定量:主要进展与挑战
Tumor mutational burden quantification from targeted gene panels: major advancements and challenges.
机构信息
Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Via Adamello 16, 20139, Milan, Italy.
Department of Oncology and Hemato-Oncology, University of Milan, via Santa Sofia 9, 20142, Milan, Italy.
出版信息
J Immunother Cancer. 2019 Jul 15;7(1):183. doi: 10.1186/s40425-019-0647-4.
Tumor mutational burden (TMB), the total number of somatic coding mutations in a tumor, is emerging as a promising biomarker for immunotherapy response in cancer patients. TMB can be quantitated by a number of NGS-based sequencing technologies. Whole Exome Sequencing (WES) allows comprehensive measurement of TMB and is considered the gold standard. However, to date WES remains confined to research settings, due to high cost of the large genomic space sequenced. In the clinical setting, instead, targeted enrichment panels (gene panels) of various genomic sizes are emerging as the routine technology for TMB assessment. This stimulated the development of various methods for panel-based TMB quantification, and prompted the multiplication of studies assessing whether TMB can be confidently estimated from the smaller genomic space sampled by gene panels. In this review, we inventory the collection of available gene panels tested for this purpose, illustrating their technical specifications and describing their accuracy and clinical value in TMB assessment. Moreover, we highlight how various experimental, platform-related or methodological variables, as well as bioinformatic pipelines, influence panel-based TMB quantification. The lack of harmonization in panel-based TMB quantification, of adequate methods to convert TMB estimates across different panels and of robust predictive cutoffs, currently represents one of the main limitations to adopt TMB as a biomarker in clinical practice. This overview on the heterogeneous landscape of panel-based TMB quantification aims at providing a context to discuss common standards and illustrates the strong need of further validation and consolidation studies for the clinical interpretation of panel-based TMB values.
肿瘤突变负荷(TMB)是肿瘤中体细胞编码突变的总数,它正在成为癌症患者免疫治疗反应的一个有前途的生物标志物。TMB 可以通过多种基于 NGS 的测序技术进行定量。全外显子组测序(WES)可以全面测量 TMB,被认为是金标准。然而,迄今为止,由于测序的基因组空间成本高昂,WES 仍然局限于研究环境中。在临床环境中,各种大小的靶向富集面板(基因面板)作为 TMB 评估的常规技术正在出现。这刺激了基于面板的 TMB 定量方法的发展,并促使越来越多的研究评估 TMB 是否可以从基因面板采样的较小基因组空间中得到可靠估计。在这篇综述中,我们列出了为此目的测试的各种可用基因面板,展示了它们的技术规格,并描述了它们在 TMB 评估中的准确性和临床价值。此外,我们还强调了各种实验、平台相关或方法变量以及生物信息学管道如何影响基于面板的 TMB 定量。目前,基于面板的 TMB 定量缺乏协调、缺乏跨不同面板转换 TMB 估计的充分方法以及缺乏稳健的预测截止值,这是将 TMB 作为生物标志物在临床实践中采用的主要限制之一。基于面板的 TMB 定量的异质景观概述旨在提供一个讨论共同标准的背景,并说明了进一步验证和巩固研究以进行基于面板的 TMB 值的临床解释的强烈需求。
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