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具有高水平局灶性扩增的卵巢癌对曲妥珠单抗和帕妥珠单抗有反应。

Ovarian cancer with high-level focal amplification responds to trastuzumab and pertuzumab.

作者信息

Thouvenin Laure, Charrier Mélinda, Clement Sophie, Christinat Yann, Tille Jean-Christophe, Frigeri Mauro, Homicsko Krisztian, Michielin Olivier, Bodmer Alexandre, Chappuis Pierre O, McKee Thomas A, Tsantoulis Petros

机构信息

Department of Oncology, University Hospitals of Geneva (HUG), Geneva, Switzerland.

Department of Genetic Medicine, Laboratory and Pathology, University Hospitals of Geneva (HUG), Geneva, Switzerland.

出版信息

Gynecol Oncol Rep. 2021 May 19;37:100787. doi: 10.1016/j.gore.2021.100787. eCollection 2021 Aug.

Abstract

Epithelial ovarian cancer (EOC) is usually diagnosed at an advanced stage and significantly contributes to cancer mortality in women. Despite multimodal treatment associating chemotherapy and surgery, most patients ultimately progress and require palliative systemic therapy. In EOC, the efficacy of anti-HER2 agents is minimal even after selecting patients for HER2 expression. gene amplification is observed in 3-10% of patients, depending on the specific method of detection and cutoffs. We report the case of a young woman with a FIGO stage IV high-grade serous ovarian cancer with an amplification of . She was treated with the association of trastuzumab - pertuzumab after two lines of standard treatment and presented an excellent long-lasting partial response after 36 months of treatment. The association of trastuzumab and pertuzumab, without chemotherapy, has not been previously tested in this context and could be more efficacious than monotherapy with either agent. In addition, the significant benefit observed in this case could be attributed to the presence of a high-level focal amplification that is relatively rare and probably more specific than an increase in HER2 expression. In conclusion, prospective trials of the trastuzumab and pertuzumab combination should be considered in an appropriately selected EOC patient population.

摘要

上皮性卵巢癌(EOC)通常在晚期被诊断出来,并且是导致女性癌症死亡的重要原因。尽管采用了化疗和手术相结合的多模式治疗,但大多数患者最终仍会病情进展,需要姑息性全身治疗。在EOC中,即使在选择HER2表达阳性的患者后,抗HER2药物的疗效也很有限。根据具体的检测方法和临界值,3%至10%的患者可观察到基因扩增。我们报告了一例年轻女性,患有国际妇产科联盟(FIGO)IV期高级别浆液性卵巢癌,伴有[此处原文缺失基因名称]扩增。在接受了两线标准治疗后,她接受了曲妥珠单抗和帕妥珠单抗联合治疗,治疗36个月后出现了持久的显著部分缓解。曲妥珠单抗和帕妥珠单抗联合使用且不进行化疗,此前在这种情况下尚未进行过测试,可能比单一药物治疗更有效。此外,在该病例中观察到的显著益处可能归因于存在高水平的局灶性扩增,这种情况相对罕见,可能比HER2表达增加更具特异性。总之,对于适当选择的EOC患者群体,应考虑进行曲妥珠单抗和帕妥珠单抗联合治疗的前瞻性试验。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0dec/8165411/4220f1f9ddd0/gr1.jpg

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