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以循环瘤DNA为基础的分层策略,用于化学疗法加PD-1抑制剂在高级非小细胞肺癌中

Jiachen Xu¹, Rui Wan¹, Yiran Cai²

¹State Key Laboratory of Molecular Oncology, CAMS Key Laboratory of Translational Research on Lung Cancer, Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

|September 10, 2024

概括

识别晚期非小细胞肺癌 (NSCLC) 的预测标志物至关重要. 这项研究介绍了一种基于血液的基因组免疫亚型 (bGIS) 方案,使用ctDNA来个性化化疗以及PD-1抑制剂治疗以获得更好的结果.

科学领域:

在瘤学瘤学.
基因组学就是基因组学.
免疫治疗是一种免疫疗法.

背景情况:

先进的非小细胞肺癌 (NSCLC) 治疗需要有效的患者分层化疗加PD-1抑制剂.
目前的分层方法在识别组合免疫化学疗法最受益的患者方面缺乏精确性.

研究的目的:

开发和验证基于循环瘤DNA (ctDNA) 的策略,用于分层高级NSCLC患者.
为了确定预测性基因组标记物对化疗反应以及PD-1抑制剂的反应.
建立一个基于血液的综合基因组免疫亚型 (bGIS) 方案,以进行个性化治疗选择.

主要方法:

基于高通量面板的深度下一代测序和低通量全基因组ctDNA测序来自CHOICE-01研究中的460名高级NSCLC患者.
分析ctDNA状态,基于血液的瘤突变负担,瘤内部异质性和染色体不稳定性.
开发基于血液的基因组免疫亚型 (bGIS) 计划.

主要成果:

确定了ctDNA状态和基因组特征 (TMB,异质性,染色体不稳定性) 作为化疗和PD-1抑制剂疗效的预测标记.
建立了bGIS方案,证明其能够区分那些受益于联合治疗的患者.
展示了在治疗管理中动态ctDNA监测的潜力.

结论:

一个基于ctDNA的综合分层策略 (bGIS) 可以个性化第一线化疗加PD-1抑制剂治疗在先进的NSCLC.
ctDNA分析为优化治疗提供了对瘤生物学和免疫反应的宝贵见解.
基于ctDNA分层的建议治疗算法有助于个性化管理高级NSCLC.

关键词:

这是一种PD-1抑制剂.基于血液的基因组免疫亚型.化学疗法化疗化疗在循环中的瘤DNA.其他非小细胞肺癌.个性化医疗是个性化的医疗.阶层化战略的分层化策略

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