Center of Oncology and Hematology, Medical University Clinic Baselland, 4410 Liestal, Switzerland.
Center of Geriatric Medicine and Rehabilitation, Cantonal Hospital Baselland, 4101 Bruderholz, Switzerland.
Int J Mol Sci. 2024 Oct 21;25(20):11322. doi: 10.3390/ijms252011322.
In the last two decades, next-generation sequencing (NGS) has facilitated enormous progress in cancer medicine, in both diagnosis and treatment. However, the usefulness of NGS in older cancer patients is unclear. To determine the role of NGS in older cancer patients, we retrospectively assessed demographic, clinicopathologic, and disease-specific data from 100 randomly selected cancer patients (any subtype/stage) who underwent NGS testing in 2020 at our institution and compared the treatment outcomes (progression-free survival [PFS] and overall survival [OS]) in the younger and older patient cohorts (A [n = 34] and B [n = 66]: age < 70 and ≥70 years, respectively). Overall, 27% had targetable mutations, and 8% received NGS-determined targeted therapy (45% and 19% of patients with a targetable mutation in cohorts A and B, respectively; = 0.2), of whom 38% (3% of the whole cohort) benefited from the therapy (PFS > 6 months). The median OS (from diagnosis) was 192 and 197 weeks in cohorts A and B, respectively ( = 0.08). This pilot study revealed no significant age-stratified difference in the diagnostic approach and treatment strategy. A small, but relevant, proportion of the cohort (3%) benefited from NGS-determined treatment. Nevertheless, older cancer patients with targetable mutations less frequently received targetable therapies.
在过去的二十年中，下一代测序（NGS）在癌症的诊断和治疗方面取得了巨大的进展。然而，NGS 在老年癌症患者中的应用效果尚不清楚。为了确定 NGS 在老年癌症患者中的作用，我们回顾性评估了 2020 年在我们机构接受 NGS 检测的 100 名随机选择的癌症患者（任何亚型/分期）的人口统计学、临床病理学和疾病特异性数据，并比较了年轻患者队列（A [n = 34]）和老年患者队列（B [n = 66]）的治疗结果（无进展生存期[PFS]和总生存期[OS]）（年龄<70 岁和≥70 岁）。总体而言，27%的患者有可靶向突变，8%的患者接受了 NGS 确定的靶向治疗（A 队列和 B 队列中有可靶向突变的患者分别为 45%和 19%；=0.2），其中 38%（整个队列的 3%）受益于该治疗（PFS>6 个月）。A 队列和 B 队列的中位 OS（从诊断开始）分别为 192 和 197 周（=0.08）。这项初步研究显示，诊断方法和治疗策略在年龄上没有明显的分层差异。队列中有一小部分（3%）患者受益于 NGS 确定的治疗。然而，有可靶向突变的老年癌症患者接受靶向治疗的比例较低。
