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用于治疗难治性结直肠癌的精准医学

Precision Medicine for the Management of Therapy Refractory Colorectal Cancer.

作者信息

Taghizadeh Hossein, Mader Robert M, Müllauer Leonhard, Erhart Friedrich, Kautzky-Willer Alexandra, Prager Gerald W

机构信息

Department of Medicine I, Clinical Division of Oncology, Medical University of Vienna, 1090 Vienna, Austria.

Comprehensive Cancer Center Vienna, 1090 Vienna, Austria.

出版信息

J Pers Med. 2020 Dec 11;10(4):272. doi: 10.3390/jpm10040272.

Abstract

In this analysis, we examined the efficacy, feasibility, and limitations of molecular-based targeted therapies in heavily pretreated metastatic colorectal cancer (mCRC) patients after failure of all standard treatments. In this single-center, real-world retrospective analysis of our platform for precision medicine, we mapped the molecular profiles of 60 mCRC patients. Tumor samples of the patients were analyzed using next-generation sequencing panels of mutation hotspots, microsatellite instability testing, and immunohistochemistry. All profiles were reviewed by a multidisciplinary team to provide a targeted treatment recommendation after consensus discussion. In total, we detected 166 mutations in 53 patients. The five most frequently found mutations were and . In 28 cases (47% of all patients), a molecularly targeted therapy could be recommended. Eventually, 12 patients (20%) received the recommended therapy. Six patients (10%) had a clinical benefit. The median time to treatment failure was 3.1 months. Our study demonstrates the feasibility and applicability of using targeted therapies in daily clinical practice for heavily pretreated mCRC patients. This could be used as a targeted treatment option in half of the patients.

摘要

在本分析中,我们研究了在所有标准治疗均失败后,基于分子的靶向治疗对经过大量预处理的转移性结直肠癌(mCRC)患者的疗效、可行性及局限性。在这项针对我们精准医学平台的单中心、真实世界回顾性分析中,我们绘制了60例mCRC患者的分子图谱。使用突变热点的二代测序 panel、微卫星不稳定性检测及免疫组化对患者的肿瘤样本进行分析。所有图谱均由多学科团队进行审查,以便在达成共识讨论后提供靶向治疗建议。我们总共在53例患者中检测到166个突变。五个最常见的突变是……和……。在28例患者(占所有患者的47%)中,可以推荐分子靶向治疗。最终,12例患者(20%)接受了推荐的治疗。6例患者(10%)有临床获益。治疗失败的中位时间为3.1个月。我们的研究证明了在日常临床实践中对经过大量预处理的mCRC患者使用靶向治疗的可行性和适用性。这可以作为一半患者的靶向治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/070a/7768503/9c35471b8f9b/jpm-10-00272-g001.jpg

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