基于RNA测序的第一选择治疗和多发性骨髓瘤风险的确定
Martina Emde-Rajaratnam1, Susanne Beck1,2, Vladimir Benes3
1Department of Hematology and Immunology, Myeloma Center Brussels & Labor für Myelomforschung, Vrije Universiteit Brussel (VUB), Jette, Belgium.
Frontiers in immunology
|November 30, 2023
概括
通过评估免疫点和患者风险,RNA测序使得多发性骨髓瘤 (MM) 的个性化治疗选择成为可能. 这种方法指导最佳治疗选择,并改善临床环境中的患者结果.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 基因组学就是基因组学.
背景情况:
- 多发性骨髓瘤 (MM) 的免疫治疗点显示出可变的表达,限制了某些患者的治疗疗效.
- 由于患者的预后不同,适当的目标选择和风险评估至关重要.
研究的目的:
- 评估RNA测序对多发性骨髓瘤 (MM) 患者分层的可行性.
- 通过基因表达分析 (GEP) 识别可操作的免疫标并评估风险得分.
- 为了比较MM不同阶段的目标表达,并在独立的队列中验证研究结果.
主要方法:
- 在多中心试验中对RNA测序的可行性评估 (GMMG-MM5,n=604).
- 在临床队列 (n=535) 的净化恶性血细胞上进行了RNA测序,GEP和iFISH.
- 目标表达与前体细胞,MGUS,无症状,复发MM和细胞系的比较;在MMRF CoMMpass队列 (n=767) 中进行验证.
主要成果:
- 在90.8%的患者中,RNA测序是可行的.
- 确定了19个可操作的免疫点,在MM中具有不同的表达模式,包括表达损失或异常表达的点.
- 开发了基于RNA测序的风险评分 (例如,LfM-HRS),与生存相关,并识别了传统分期 (R-ISS) 遗漏的高风险患者.
结论:
- RNA测序是一种可行的和有价值的工具,用于在多发性骨髓瘤的常规临床评估.
- 基于GEP的风险分层和目标识别可以指导个性化治疗策略.
- 这种方法有助于为多发性骨髓瘤的首选疗法做出明智的决定.
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