Sawada Kiyoka, Nakayama Kentaro, Nakamura Kohei, Yoshimura Yuki, Razia Sultana, Ishikawa Masako, Yamashita Hitomi, Ishibashi Tomoka, Sato Seiya, Kyo Satoru
Department of Obstetrics and Gynecology, Shimane University School of Medicine, Izumo 693-8501, Japan.
Healthcare (Basel). 2021 Oct 19;9(10):1395. doi: 10.3390/healthcare9101395.
Recent advances in next-generation sequencing and genome medicine have contributed to treatment decisions in patients with cancer. Most advanced gynecological cancers develop resistance to chemotherapy and have a poor prognosis. Therefore, we conducted genomic tests in gynecological tumors to examine the efficacy and clinical feasibility of genotype-matched therapy. Target sequencing was performed in 20 cases of gynecological cancers (cervical cancer, 6; endometrial cancer, 6; and ovarian cancer, 6). Both actionable and druggable genes were identified in 95% (19/20) of the cases. Among them, seven patients (35%) received genotype-matched therapy, which was effective in three patients. Of the three patients, one patient with a mutation received everolimus, another patient with a mutation received everolimus and letrozole, and the patient with a mutation received olaparib. Subsequently, disease control in these three patients lasted for more than half a year. However, all patients relapsed between 9 and 13 months after the initiation of genotype-matched therapy. In this study, the response rate of genotype-matched therapy was 43% (3/7), which may have contributed to improved prognoses. Therefore, genotype-matched therapies may help patients with refractory gynecological cancers achieve better outcomes.
新一代测序和基因组医学的最新进展为癌症患者的治疗决策提供了帮助。大多数晚期妇科癌症会对化疗产生耐药性，预后较差。因此，我们对妇科肿瘤进行了基因组检测，以研究基因型匹配疗法的疗效和临床可行性。对20例妇科癌症（宫颈癌6例、子宫内膜癌6例、卵巢癌6例）进行了靶向测序。95%（19/20）的病例中鉴定出了可操作和可用药的基因。其中，7例患者（35%）接受了基因型匹配疗法，3例患者治疗有效。在这3例患者中，1例携带 突变的患者接受了依维莫司治疗，另1例携带 突变的患者接受了依维莫司和来曲唑治疗，携带 突变的患者接受了奥拉帕利治疗。随后，这3例患者的疾病控制持续了半年以上。然而，所有患者在基因型匹配疗法开始后的9至13个月内均复发。在本研究中，基因型匹配疗法的缓解率为43%（3/7），这可能有助于改善预后。因此，基因型匹配疗法可能有助于难治性妇科癌症患者获得更好的治疗效果。
