El Helali Aya, Lam Tai-Chung, Ko Elaine Yee-Ling, Shih David J H, Chan Chun Kau, Wong Charlene H L, Wong Jason W H, Cheung Lydia W T, Lau Johnny K S, Liu Anthony P Y, Chan Ann S Y, Loong Herbert H, Lam Stephen Tak Sum, Chan Godfrey Chi-Fung, Lee Victor H F, Yuen Kwok Keung, Ng Wai-Tong, Lee Anne W M, Ma Edmond S K
Department of Clinical Oncology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
Oncology Medical Center, The University of Hong Kong - Shenzhen Hospital, Shenzhen, China.
Lancet Reg Health West Pac. 2023 Apr 28;36:100775. doi: 10.1016/j.lanwpc.2023.100775. eCollection 2023 Jul.
The integration of next-generation sequencing (NGS) comprehensive gene profiling (CGP) into clinical practice is playing an increasingly important role in oncology. Therefore, the HKU-HKSH Multi-disciplinary Molecular Tumour Board (MTB) was established to advance precision oncology in Hong Kong. A multicenter retrospective study investigated the feasibility of the HKU-HKSH MTB in determining genome-guided therapy for treatment-refractory solid cancers in Hong Kong.
Patients who were presented at the HKU-HKSH MTB between August 2018 and June 2022 were included in this study. The primary study endpoints were the proportion of patients who receive MTB-guided therapy based on genomic analysis and overall survival (OS). Secondary endpoints included the proportion of patients with actionable genomic alterations, objective response rate (ORR), and disease control rate (DCR). The Kaplan-Meier method was used in the survival analyses, and hazard ratios were calculated using univariate Cox regression.
122 patients were reviewed at the HKU-HKSH MTB, and 63% (n = 77) adopted treatment per the MTB recommendations. These patients achieved a significantly longer median OS than those who did not receive MTB-guided therapy (12.7 months vs. 5.2 months, P = 0.0073). Their ORR and DCR were 29% and 65%, respectively.
Our study demonstrated that among patients with heavily pre-treated advanced solid cancers, MTB-guided treatment could positively impact survival outcomes, thus illustrating the applicability of NGS CGPs in real-world clinical practice.
The study was supported by the Li Shu Pui Medical Foundation. Dr Aya El Helali was supported by the Li Shu Pui Medical Foundation Fellowship grant from the Li Shu Pui Medical Foundation. Funders had no role in study design, data collection, data analysis, interpretation, or writing of the report.
将下一代测序（NGS）全面基因谱分析（CGP）整合到临床实践中，在肿瘤学领域正发挥着越来越重要的作用。因此，香港大学-香港港安医院多学科分子肿瘤委员会（MTB）成立，以推动香港的精准肿瘤学发展。一项多中心回顾性研究调查了香港大学-香港港安医院MTB在确定香港难治性实体癌的基因组指导治疗方面的可行性。
纳入2018年8月至2022年6月期间在香港大学-香港港安医院MTB就诊的患者。主要研究终点是基于基因组分析接受MTB指导治疗的患者比例和总生存期（OS）。次要终点包括具有可操作基因组改变的患者比例、客观缓解率（ORR）和疾病控制率（DCR）。生存分析采用Kaplan-Meier方法，使用单变量Cox回归计算风险比。
香港大学-香港港安医院MTB对122例患者进行了评估，63%（n = 77）的患者按照MTB的建议接受了治疗。这些患者的中位OS明显长于未接受MTB指导治疗的患者（12.7个月对5.2个月，P = 0.0073）。他们的ORR和DCR分别为29%和65%。
我们的研究表明，在经过大量前期治疗的晚期实体癌患者中，MTB指导的治疗可以对生存结果产生积极影响，从而说明了NGS CGP在实际临床实践中的适用性。
该研究由李树培医学基金会资助。阿亚·埃尔·赫拉利博士获得了李树培医学基金会的李树培医学基金会奖学金资助。资助者在研究设计、数据收集、数据分析、解读或报告撰写方面没有参与。
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