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具有 CCNE1 扩增的 I 期癌症患者的临床特征和结局:MD 安德森经验。

Clinical characteristics and outcomes of phase I cancer patients with CCNE1 amplification: MD Anderson experiences.

机构信息

Department of Thoracic Surgery, Xuanwu Hospital Capital Medical University, Beijing, China.

Department of Investigational Cancer Therapeutics, Unit 0455, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA.

出版信息

Sci Rep. 2022 May 24;12(1):8701. doi: 10.1038/s41598-022-12669-5.

Abstract

Cyclin E is frequently encoded by CCNE1 gene amplification in various malignancies. We reviewed the medical records of patients with solid tumors displaying CCNE1 amplification to determine the effect of this amplification for future therapeutic development. We reviewed the medical records of patients with advanced solid tumors harboring CCNE1 amplification who were seen at the phase I clinic between September 1, 2012, and December 31, 2019. Among 79 patients with solid tumors harboring CCNE1 amplification, 56 (71%) received phase 1 clinical trial therapy, 39 (49%) had 3 or more concurrent genomic aberrances, and 52 (66%) had a concurrent TP53 mutation. The median overall survival (OS) after patients' initial phase I visit was 8.9 months and after their initial metastasis diagnosis was 41.4 months. We identified four factors associated with poor risk: age < 45 years, body mass index ≥ 25 kg/m, presence of the TP53 mutation, and elevated LDH > upper limit of normal. In patients treated with gene aberration-related therapy, anti-angiogenic therapy led to significantly longer OS after their initial phase I trial therapy than those who did not: 26 months versus 7.4 months, respectively (P = 0.04). This study provided preliminary evidence that CCNE1 amplification was associated with frequent TP53 mutation and aggressive clinical outcomes. Survival benefit was observed in patients who received antiangiogenic therapy and gene aberration-related treatment, supporting the future development of a personalized approach to combine gene aberration-related therapy with antiangiogenesis for the treatment of advanced malignancies harboring CCNE1 amplification.

摘要

细胞周期蛋白 E 常因 CCNE1 基因扩增而在多种恶性肿瘤中编码。我们复习了显示 CCNE1 扩增的实体瘤患者的病历,以确定这种扩增对未来治疗发展的影响。我们复习了 2012 年 9 月 1 日至 2019 年 12 月 31 日期间在 I 期临床诊所就诊的具有 CCNE1 扩增的晚期实体瘤患者的病历。在 79 例具有 CCNE1 扩增的实体瘤患者中,56 例(71%)接受了 I 期临床试验治疗,39 例(49%)存在 3 种或更多种同时存在的基因组异常,52 例(66%)存在同时存在的 TP53 突变。患者首次 I 期就诊后中位总生存期(OS)为 8.9 个月,首次转移诊断后为 41.4 个月。我们确定了与不良风险相关的四个因素:年龄<45 岁,BMI≥25kg/m2,存在 TP53 突变和升高的 LDH>正常值上限。在接受基因异常相关治疗的患者中,抗血管生成治疗在首次 I 期试验治疗后导致 OS 明显延长,分别为 26 个月和 7.4 个月(P=0.04)。本研究初步表明 CCNE1 扩增与频繁的 TP53 突变和侵袭性临床结局相关。在接受抗血管生成治疗和基因异常相关治疗的患者中观察到生存获益,支持未来开发一种个性化方法,将基因异常相关治疗与抗血管生成相结合,用于治疗具有 CCNE1 扩增的晚期恶性肿瘤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a9f/9130298/9ad1bde5b10c/41598_2022_12669_Fig1_HTML.jpg

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