解决青少年和青年癌症基因组图谱和针对性治疗方法方面的知识差距。
Addressing the knowledge gap in the genomic landscape and tailored therapeutic approaches to adolescent and young adult cancers.
机构信息
Department of Genomic Medicine, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Koto-ku, Tokyo; Department of Clinical Genetic Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Koto-ku, Tokyo.
Department of Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Koto-ku, Tokyo; Department of Advanced Medical Development, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Koto-ku, Tokyo.
出版信息
ESMO Open. 2024 Aug;9(8):103659. doi: 10.1016/j.esmoop.2024.103659. Epub 2024 Aug 12.
BACKGROUND
Adolescents and young adults (AYAs) represent a small proportion of patients with cancer. The genomic profiles of AYA patients with cancer are not well-studied, and outcomes of genome-matched therapies remain largely unknown.
PATIENTS AND METHODS
We investigated differences between Japanese AYA and older adult (OA) patients in genomic alterations, therapeutic evidence levels, and genome-matched therapy usage by cancer type. We also assessed treatment outcomes.
RESULTS
AYA patients accounted for 8.3% of 876 cases. Microsatellite instability-high and/or tumor mutation burden was less common in AYA patients (1.4% versus 7.7% in OA; P = 0.05). However, BRCA1 alterations were more common in AYA patients with breast cancer (27.3% versus 1.7% in OA; P = 0.01), as were MYC alterations in AYA patients with colorectal cancer (23.5% versus 5.8% in OA; P = 0.02) and sarcoma (31.3% versus 3.4% in OA; P = 0.01). Genome-matched therapy use was similar between groups, with overall survival tending to improve in both. However, in AYA patients, the small number of patients prevented statistical significance. Comprehensive genomic profiling-guided genome-matched therapy yielded encouraging results, with progression-free survival of 9.0 months in AYA versus 3.7 months in OA patients (P = 0.59).
CONCLUSION
Our study suggests that tailored therapeutic approaches can benefit cancer patients regardless of age.
背景
青少年和年轻人（AYA）在癌症患者中占比较小。AYA 癌症患者的基因组特征尚未得到充分研究，基于基因组匹配的治疗效果也知之甚少。
患者和方法
我们研究了日本 AYA 和老年（OA）患者在基因组改变、治疗证据水平以及按癌症类型使用基因组匹配治疗方面的差异。我们还评估了治疗结果。
结果
AYA 患者占 876 例患者的 8.3%。微卫星不稳定性高和/或肿瘤突变负担在 AYA 患者中较少见（1.4%比 OA 患者的 7.7%；P=0.05）。然而，BRCA1 改变在 AYA 乳腺癌患者中更为常见（27.3%比 OA 患者的 1.7%；P=0.01），在 AYA 结直肠癌患者中 MYC 改变更为常见（23.5%比 OA 患者的 5.8%；P=0.02），在 AYA 肉瘤患者中更为常见（31.3%比 OA 患者的 3.4%；P=0.01）。两组之间的基因组匹配治疗使用情况相似，总体生存率均有提高。然而，在 AYA 患者中，患者数量较少，无法得出统计学意义。综合基因组分析指导下的基因组匹配治疗取得了令人鼓舞的结果，AYA 患者的无进展生存期为 9.0 个月，而 OA 患者为 3.7 个月（P=0.59）。
结论
我们的研究表明，无论年龄大小，针对特定患者的治疗方法都可以使癌症患者受益。
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