在患有HER2-放大转移性结肠直肠癌的患者中,现实世界的治疗模式:临床基因组数据库研究
John H Strickler1, Ling-I Hsu2, Phoebe Wright2
1Division of Medical Oncology, Duke University Medical Center, Durham, North Carolina.
Journal of the National Comprehensive Cancer Network : JNCCN
|August 7, 2023
概括
在2018年之后,HER2阳性转移性结直肠癌 (mCRC) 的治疗模式发生了变化,HER2导向疗法的使用增加. 然而,针对性治疗在这个患者群体中仍然未得到充分利用.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 基因组学就是基因组学.
背景情况:
- HER2放大 (HER2+) 影响大约3%的转移性结直肠癌 (mCRC) 患者.
- 现在NCCN指南包括HER2导向疗法,但FDA批准的选择在历史上是有限的.
- 这项研究调查了在2018年之前和之后的HER2+ mCRC患者的现实世界治疗转移.
研究的目的:
- 检查 HER2 阳性转移性结直肠癌 (mCRC) 患者的现实世界治疗模式.
- 评估 HER2+ mCRC 在提高对 HER2 导向疗法的认识之前和之后的治疗演变.
- 根据治疗类型评估实际时间到下一次治疗 (rwTTNT).
主要方法:
- 使用GuardantINFORM数据库 (使用Guardant360基因组测试的索赔数据) 的回顾性观察研究.
- 包括142名被诊断患有mCRC的患者 (≥18岁) (2014年1月~2020年9月) 和确认的ERBB2放大.
- 分析了治疗模式,并计算了rwTTNT.
主要成果:
- 治疗模式异质,并在2018年后发生了变化.
- 在2018年之前,抗VEGF治疗 (含或不含化疗) 是最常见的 (31.6%).
- 在2018年之后,HER2导向疗法成为最常见的 (36.5%).
- 中位数的rwTTNT为8.4个月;在HER2导向疗法 (11.0个月) 和非HER2导向疗法 (7.2个月) 中,数值较长.
结论:
- 尽管包括NCCN指南,但许多HER2+ mCRC患者没有接受HER2导向治疗.
- 不同类型的治疗模式表明未定义的护理标准和针对性治疗的不足利用.
- 需要提高认识和新疗法,以改善针对HER2+mCRC的向治疗策略.
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