在黑人和白人男性中进行生物标志物导向治疗,这些男性患有转移性割抵抗性前列腺癌
Clara Hwang1, Nicholas C Henderson2, Shih-Chun Chu2
1Henry Ford Health, Detroit, Michigan.
JAMA network open
|September 18, 2023
概括
患有转移性割耐药前列腺癌 (mCRPC) 的黑人男性表现出更高的特定可操作分子变异率,包括不匹配修复缺陷 (MMRD) 或高微观卫星不稳定性 (MSI-H). 尽管针对性治疗的使用率较低,但黑人和白人患者的临床结果相似.
科学领域:
- 在瘤学瘤学.
- 遗传学 遗传学 是一个
- 健康差异 在健康上的差异
背景情况:
- 黑人男性面临更高的前列腺癌发病率和死亡率.
- 对于患有转移性割耐性前列腺癌 (mCRPC) 的黑人男性,精确瘤学的差异尚不清楚.
研究的目的:
- 为了比较精准医学数据和黑人和白人男性之间诊断出mCRPC的临床结果.
主要方法:
- 使用PROMISE联盟的临床基因组数据进行的回顾性队列研究 (2020年4月至2021年12月).
- 分析包括962名患者 (204名黑人,758名白人) 具有mCRPC和分子数据.
- 主要结局:可操作的分子变化的频率 (MMRD/MSI-H,HRD,高TMB).
主要成果:
- 基于血液的测试在黑人男性 (48.7%) 与白人男性 (36.4%) 之间更为常见.
- 可采取行动的改变率总体上相似 (32.8%与29.1%),但MMRD/MSI-H在黑人男性中更高 (9.1%与4.9%).
- 黑人男性的PTEN和TMPRSS变化较少,但接受匹配的向治疗的频率较低 (33.5%对53.5%).
结论:
- 患有mCRPC的黑人男性表现出明显的分子谱,包括更高的MMRD/MSI-H率.
- 尽管有针对性治疗利用的差异,但种族群体之间的临床结果 (反应率,存活率) 是可比的.
- 研究结果强调,需要解决黑人男性精密瘤治疗的潜在障碍.
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