下一代测序用于指导复发或转移性癌症患者匹配的向疗法
Farasat Kazmi1,2, Nipun Shrestha3, Tik Fung Dave Liu2
1Department of Oncology, University of Oxford, Oxford, UK.
The Cochrane database of systematic reviews
|March 23, 2025
概括
根据下一代测序 (NGS) 引导的匹配向疗法 (MTT) 显著延迟了晚期癌症的进展. 虽然生存益处有限,但这种方法为耐火性癌症患者提供了有价值的选择.
科学领域:
- 在瘤学瘤学.
- 基因组学就是基因组学.
- 临床试验 临床试验
背景情况:
- 匹配的向疗法 (MTT) 在新诊断的癌症中显示出有效性,但在复发或晚期疾病中缺乏证据.
- 在晚期癌症中感知到瘤异质性导致下一代测序 (NGS) 的优先级较低,并阻止其使用.
- 需要证据来支持NGS在指导MTT治疗耐火性癌症方面的实用性.
研究的目的:
- 在先进癌症的随机对照试验中评估匹配的向疗法 (MTT) 的益处和危害.
主要方法:
- 在多个数据库 (CENTRAL,MEDLINE,Embase,ClinicalTrials.gov,WHO-ICTRP) 进行系统搜索,截至2024年10月.
- 包括随机对照试验 (RCT) 涉及先进/耐药癌症的参与者,这些参与者在先前治疗中进展.
- 结果分析包括无进展生存 (PFS),整体生存 (OS),整体反应率 (ORR),不良事件 (AE) 和生活质量 (QOL).
主要成果:
- 与标准护理相比,MTT可能会减少34%的疾病进展 (中度确定性证据).
- 与标准护理相结合的MTT可能会将进展率降低39%,死亡率降低21% (中度确定性证据).
- 与非匹配的向疗法相比,MTT可能会减少24%的进展 (中度确定性证据).
结论:
- 与标准疗法相比,NGS引导的MTT在晚期癌症中延长了无进展的生存期.
- 有有限的证据表明,MTT可以改善整体生存率或生活质量.
- 本次审查支持为晚期癌症患者提供公平的NGS接入,以便获得基因型匹配疗法.
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