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ヒスティオサイト性腫瘍患者におけるMEK抑制の有効性
Eli L Diamond1,2, Benjamin H Durham3,4, Gary A Ulaner2,5
1Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Nature
|March 15, 2019
まとめ
ヒスティオサイト性腫瘍はMAPKのシグナル伝達に依存しています コビメチニブ (MEK阻害剤) の試験では,BRAF変異を有する患者およびそれのない患者で高い応答率を示し,すべてのヒスティオサイトーシス型に対する新しい治療法を提供した.
科学分野:
- 腫瘍学
- 血液学
- 分子生物学
背景:
- ヒスティオサイト性腫瘍は,様々なクローナルの造血疾患である.
- ミトゲン活性化タンパク質キナーゼ (MAPK) 経路の変異は一般的です.
- 標的治療はBRAF V600変異にはありますが,他の変異にはありません.
研究 の 目的:
- ヒスティオサイト性腫瘍のERK依存性を調査する.
- 腫瘍の遺伝子型に関係なく,ヒスティオサイトーゼの患者におけるコビメチニブ (MEK阻害剤) の有効性を評価する.
- 治療中の患者におけるMAPK経路の変異を特徴づける.
主な方法:
- コビメチニブを使った 概念実証臨床試験
- 腫瘍の遺伝子型に関係なくヒスティオシトーシスの患者の登録
- ERK活性化能力に対するMAPK変異の並行特徴付け.
主要な成果:
- 治療を受けた18人の患者で,全体的に89%の応答率が観察されました.
- 1年後の生存率は100%で,発症しない生存率は94%でした.
- コビメチニブは,様々なMAPK経路変異 (ARAF,BRAF,RAF1,NRAS,KRAS,MEK1,MEK2) に対して有効であった.
結論:
- ヒスティオサイト性腫瘍は,MAPKシグナル伝達に大きく依存している.
- コビメチニブによるMEK阻害は,ヒスティオサイト性腫瘍の全スペクトルの有効な治療策である.
- この研究は,分子標的治療の利点をヒスティオシトーシスのすべての患者に拡大します.
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