如果它是固体瘤的目标,那么它可能是血液癌症的目标:弥合大沟
Jacob J Adashek1, Javier L Munoz2, Razelle Kurzrock3
1Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins Hospital, Baltimore, MD, USA.
Med (New York, N.Y.)
|December 17, 2024
概括
无瘤批准针对癌症中的特定基因变异,提供高响应率和获得罕见癌症治疗的机会. 未来的研究应该包括固体和血液癌症,以获得更广泛的适用性.
科学领域:
- 在瘤学瘤学.
- 基因组学就是基因组学.
- 精准医学是一门精准的医学.
背景情况:
- 美国食品和药物管理局 (FDA) 的瘤不可知批准正在通过针对特定的分子变化而不是瘤位置来彻底改变癌症治疗.
- 这种方法已经证明了显著的响应率,并扩大了罕见或超罕见恶性瘤患者的药物获取.
研究的目的:
- 审查瘤学中瘤不可知性批准的当前情况.
- 突出这一基因组驱动方法的生物学理由和临床益处.
- 提议扩大未来的组织不可知性研究,包括固体癌症和血液癌症.
主要方法:
- 审查现有的美国FDA批准的瘤不可知疗法及其相应的分子标 (例如,NTRK融合,BRAF突变,微卫星不稳定性).
- 对针对不同癌症类型中常见的分子异常的生物基础的分析.
- 在固体和血液恶性瘤中识别共享的可用药物点.
主要成果:
- 已经批准了几种瘤不可知疗法,包括larotrectinib/entrectinib/repotrectinib,selpercatinib,dabrafenib/trametinib,pembrolizumab/dostarlimab和trastuzumab deruxtecan. 这些疗法包括:
- 佩米加替尼 (pemigatinib) 已被批准用于FGFR1重组的骨髓状/淋巴状瘤.
- 同样的驱动分子异常 (例如,BRAF V600E,NTRK融合,PD-L1放大) 在固体和血液癌症中都存在,对向治疗有反应.
结论:
- 无瘤,基因组驱动的方法是非常有效的,并解决瘤学未满足的需求.
- 在未来基于生物标志物,组织不可知的篮子研究和批准中,包括固体癌症和血液癌症有很强的理由.
- 通过组织不可知疗法弥合固体和血液性恶性瘤之间的差距,将进一步提高精确瘤学.
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