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利用癌症基因组分析进行头颈部恶性肿瘤精准肿瘤学的效用。

Utility of Precision Oncology Using Cancer Genomic Profiling for Head and Neck Malignancies.

机构信息

Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

出版信息

In Vivo. 2023 Sep-Oct;37(5):2147-2154. doi: 10.21873/invivo.13312.

Abstract

BACKGROUND/AIM: In recent years, individual patient cancer genomic profiling (CGP) has become more accessible, allowing determination of therapeutic strategies using driver gene mutations in cancer therapy. However, this precision oncology approach, tailored to specific patients, remains experimental. In this study, we verified the feasibility and benefit of using CGP to guide treatment of malignant head and neck tumors. We aimed to evaluate the profiling and clinical courses of patients with head and neck malignancies who underwent CGP and determine the extent to which CGP for head and neck malignancies has resulted in beneficial drug administration.

PATIENTS AND METHODS

We analyzed CGP results, prognosis, and drug administration status in 27 patients. These patients had completed (or were expected to complete) standard therapy or had rare cancers without standard therapy.

RESULTS

At least one somatic actionable gene alteration was seen in 25 (92.6%) patients, with a median number of actionable alterations per patient of 4 (range=0-11). Drugs in clinical trials were recommended to 22 (81.5%) patients, but none could participate. However, 3 patients (11.1%) could use approved drugs off-label based on CGP results. The most common genetic abnormality was TP53 (66.7%), with TP53 mutations leading to poor prognosis.

CONCLUSION

CGP is clinically useful and serves as a bridge to increase the number of therapeutic options. However, candidate drugs confirmed using CGP may be ineffective when administered. Therefore, oncologists should not blindly accept CGP therapeutic recommendations but should make recommendations that lead to optimal therapies after proper verification.

摘要

背景/目的:近年来,个体化患者癌症基因组分析(CGP)变得更加普及,能够通过癌症治疗中的驱动基因突变来确定治疗策略。然而,这种针对特定患者的精准肿瘤学方法仍处于试验阶段。本研究旨在验证使用 CGP 指导恶性头颈部肿瘤治疗的可行性和获益。我们旨在评估接受 CGP 的头颈部恶性肿瘤患者的分析结果和临床过程,并确定 CGP 对头颈部恶性肿瘤的获益药物管理程度。

患者和方法

我们分析了 27 例患者的 CGP 结果、预后和药物管理状况。这些患者已完成(或预计完成)标准治疗,或患有罕见癌症而无标准治疗。

结果

25 例(92.6%)患者至少存在 1 个体细胞可操作基因改变,中位患者可操作改变数为 4 个(范围=0-11)。22 例(81.5%)患者被推荐使用临床试验中的药物,但均无法参与。然而,根据 CGP 结果,有 3 例(11.1%)患者可以使用批准的药物进行标签外治疗。最常见的遗传异常是 TP53(66.7%),TP53 突变导致预后不良。

结论

CGP 在临床上是有用的,可以作为增加治疗选择数量的桥梁。然而,使用 CGP 确认的候选药物在给药时可能无效。因此,肿瘤学家不应盲目接受 CGP 的治疗建议,而应在适当验证后提出能使患者获益的最佳治疗建议。

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