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循环游离DNA在库欣综合征伴胰腺神经内分泌癌治疗中的应用

cfDNA in pancreatic neuroendocrine carcinoma management with Cushing's syndrome.

作者信息

Gerard Laura, Barthelemy David, Gauthier Arnaud, Hervieu Valerie, Lopez Jonathan, Gibert Benjamin, Lasolle Helene, Chardon Laurence, Garcia Jessica, Raverot Gérald, Payen Léa, Walter Thomas

机构信息

Départment d'Oncologie Médicale, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.

European NeuroEndocrine Tumours Society (ENETS) Lyon Center of Excellence, Lyon, France.

出版信息

Endocr Oncol. 2021 Jul 13;1(1):K1-K6. doi: 10.1530/EO-21-0012. eCollection 2021 Jan.

DOI:10.1530/EO-21-0012
PMID:37435182
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10265538/
Abstract

SUMMARY

We report a case of metastatic pancreatic neuroendocrine carcinoma associated with paraneoplastic Cushing's syndrome, successively treated with five lines of treatment (platin-etoposide, LV5FU2-dacarbazine, FOLFIRINOX, pembrolizumab, and paclitaxel) and anti-secretory treatment. Circulating-free DNA (cfDNA) was analysed at each morphological evaluation starting from the second-line treatment. cfDNA changes were well correlated with the disease course, and cfDNA may be used as a predictive marker and/or as an early marker of response. In addition, the absolute count of atypical cells was elevated upon disease progression.

LEARNING POINTS

cfDNA changes were well correlated with the Cushing's syndrome course and with the tumour burden changes assessed by laboratory markers and by RECIST criteria.cfDNA analysis was used to determine the pharmacogenetic patterns of the present patient.An elevated number of atypical circulating cells was noticed upon disease progression.

摘要

摘要

我们报告了一例与副肿瘤性库欣综合征相关的转移性胰腺神经内分泌癌病例，先后接受了五线治疗（铂类-依托泊苷、LV5FU2-达卡巴嗪、FOLFIRINOX、帕博利珠单抗和紫杉醇）及抗分泌治疗。从二线治疗开始，在每次形态学评估时分析游离循环DNA（cfDNA）。cfDNA变化与疾病进程密切相关，cfDNA可用作预测标志物和/或反应的早期标志物。此外，疾病进展时非典型细胞的绝对计数升高。

学习要点

cfDNA变化与库欣综合征病程以及通过实验室标志物和RECIST标准评估的肿瘤负荷变化密切相关。cfDNA分析用于确定本患者的药物遗传学模式。疾病进展时发现非典型循环细胞数量增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ffc/10265538/df2fc427f97c/EO-21-0012fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ffc/10265538/cb4715d34169/EO-21-0012fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ffc/10265538/79a2ee6a2af9/EO-21-0012fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ffc/10265538/df2fc427f97c/EO-21-0012fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ffc/10265538/cb4715d34169/EO-21-0012fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ffc/10265538/79a2ee6a2af9/EO-21-0012fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ffc/10265538/df2fc427f97c/EO-21-0012fig3.jpg

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根据 UGT1A1 基因型，在转移性结直肠癌患者中进行 FOLFIRI 联合高剂量伊立替康（HD-FOLFIRI）的药效学和安全性的临床随机 II 期试验。
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