在临床实践中,癌症基因组资料测试对晚期或转移性实体瘤的预后影响
Ippei Fukada1,2, Seiichi Mori3, Naomi Hayashi1
1Genomic Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan.
Cancer science
|October 20, 2023
概括
癌症基因组概况 (CGP) 测试可以识别突变,但有限的药物可获得性会影响患者的结果. 实现治疗反应,而不仅仅是测试,可能会改善癌症患者的整体存活率.
科学领域:
- 在瘤学瘤学.
- 基因组学就是基因组学.
- 临床研究 临床研究
背景情况:
- 癌症基因组概况 (CGP) 测试是日本的一项常规临床实践,由国家医疗保险覆盖.
- CGP测试对患者预后的影响仍然不清楚,特别是在药物可获得性方面.
研究的目的:
- 调查CGP测试,药物可用性和患者预后之间的关系.
- 在现实临床环境中评估基因组匹配疗法的有效性.
主要方法:
- 在2019年11月至2022年10月期间接受CGP测试的713名患者的回顾性分析.
- 使用卡普兰-梅尔和日志等级测试分析了整体生存 (OS).
- 记录了分子瘤委员会建议和实际接受的治疗方法.
主要成果:
- 在CGP测试中,在95.5%的患者中检测到突变,在61.6%的患者中发现了可操作的突变.
- 只有40.0%的患者接受了治疗建议,只有45名患者 (6.3%) 接受了基于突变的治疗.
- 在接受基因组匹配疗法和不接受基因组匹配疗法治疗的患者之间没有观察到OS的显著差异 (p=0.285).
- 与进展性疾病患者 (9.8个月,p=0.013) 相比,获得部分反应或稳定疾病的患者的中位寿命明显更长 (26.5个月).
结论:
- 对基因突变向治疗的临床反应,而不是单独进行CGP测试,可能会改善癌症患者的预后.
- 在CGP测试后增加药物可访问率对于提高治疗疗效和患者结果至关重要.
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