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胚胎DNA损伤反应基因突变作为免疫检查点抑制剂疗效的预测生物标志物
Michael J Dennis1,2, Sophia Bylsma3, Lisa Madlensky4,5
1Division of Medical Oncology, Moores Cancer Center, University of California, San Diego, San Diego, CA, United States.
Frontiers in immunology
|February 13, 2024
概括
生殖线DNA损伤反应 (DDR) 突变显著提高了癌症患者的免疫检查点抑制剂 (ICI) 疗效. 这些突变在不增加毒性的情况下增强治疗反应,为治疗选择提供了有前途的生物标志物.
科学领域:
- 在瘤学瘤学.
- 遗传学 是一个遗传学.
- 免疫治疗是一种免疫疗法.
背景情况:
- 缺陷的DNA损伤反应 (DDR) 与免疫检查点抑制剂 (ICI) 的有效性和免疫激活有关.
- 评估生殖系DDR突变对ICI反应和毒性的影响对于优化癌症治疗至关重要.
研究的目的:
- 评估致病性或可能致病性 (P/LP) 生殖系DDR突变与ICI治疗的反应之间的关联.
- 为了确定生殖线DDR突变是否会影响ICI治疗的毒性概况.
主要方法:
- 对131名癌症患者进行回顾性分析,这些患者接受了生殖线DNA测试和ICI治疗.
- 具有和没有DDR突变的患者之间的客观反应率 (ORR) 和与免疫相关的不良事件的比较.
主要成果:
- 患有DDR突变的患者 (DDR+) 与DDR阴性患者相比 (62%) 的ORR显著更高 (23%).
- 亚组分析显示,DDR+患者在不匹配修复 (MMR),DDR途径与完整的MMR (DDR+MMRi) 和同源重组 (HR) 亚组中增强了ORR.
- 在DDR+患者中,同时使用化疗或氨酸激酶抑制剂改善了ORR,但并没有显著增加不良事件.
结论:
- P/LP生殖系DDR突变与对ICI治疗的增强反应有关.
- 生殖线DDR突变可以作为ICI疗效的预测生物标志物,而不会显著增加毒性.
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