在社区瘤学环境中,广泛基因组测序与晚期非小细胞肺癌患者的存活率的关联
Carolyn J Presley1, Daiwei Tang2, Pamela R Soulos3
1The Ohio State University, Medical Oncology, Columbus.
JAMA
|August 9, 2018
概括
在高级非小细胞肺癌 (NSCLC) 中,广泛基因组测序没有改善社区环境中的生存结果. 这项全面的测试为少数患者提供了治疗信息,突显了进一步研究的必要性.
科学领域:
- 癌症学
- 基因组学
- 临床研究
背景情况:
- 广泛基因组测序 (BGS) 越来越多地用于高级非小细胞肺癌 (NSCLC).
- 关于BGS对社区瘤诊所治疗选择和生存的影响的数据有限.
研究的目的:
- 将接受BGS和接受常规EGFR/ ALK测试的晚期NSCLC患者的临床结果进行比较.
- 评估BGS与真实世界社区瘤环境中的生存之间的关联.
主要方法:
- 从2011年1月至2016年7月的晚期NSCLC患者 (IIIB/IV期或不可切除) 的回顾性队列研究.
- 接受BGS (≥30基因) 患者与常规EGFR/ ALK测试的比较.
- 主要结局:12个月死亡率和整体存活率;次要结局:治疗模式和遗传变化.
主要成果:
- 在5688名患者中,15. 4%接受了BGS. 只有4. 5%的BGS患者接受了基于BGS结果的向治疗.
- 在BGS组中,未经调整的12个月死亡率高于常规检测 (35. 9%).
- 仪器变量和倾向分数匹配的分析显示BGS与12个月死亡率或整体存活率的改善之间没有显著的关联.
结论:
- 在社区瘤学中,BGS直接为少数晚期NSCLC患者提供治疗信息.
- 在该患者队列中,BGS与改善的生存结果没有独立关联.
- 需要进一步研究以优化BGS在指导高级NSCLC治疗决策中的效用.
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