在美国退伍军人中进行体质瘤下一代测序,这些退伍军人患有转移性前列腺癌
Luca F Valle1,2,3, Jiannong Li4, Heena Desai5,6
1Radiation Oncology Service, Veterans Affairs (VA) Greater Los Angeles Healthcare System, Los Angeles, California.
JAMA network open
|May 12, 2025
概括
转移性前列腺癌 (mPCa) 的基因组变化因种族而异. 下一代测序 (NGS) 确定了非西班牙裔黑人和白人退伍军人之间关键路径的差异,突出了对公平精确瘤学的需要.
科学领域:
- 基因组医学是一种基因组医学.
- 前列腺癌研究前列腺癌研究.
- 卫生公平性健康公平性
背景情况:
- 国家指导方针主张在转移性前列腺癌 (mPCa) 中使用下一代测序 (NGS) 来识别可操作的变化.
- 非西班牙裔黑人男性在精确瘤学研究中代表性不足,这限制了对基因组差异的理解.
- 描述这些差异对于公平待遇策略至关重要.
研究的目的:
- 分析前列腺癌相关基因和途径的变化频谱和频率.
- 调查这些变化,种族/种族和美国退伍军人的整体存活率之间的关联.
- 为各种患者群体提供精确瘤学方法的信息.
主要方法:
- 对5015名美国退伍军人进行回顾性队列研究,mPCa接受NGS测试.
- 非西班牙裔黑人和非西班牙裔白人退伍军人之间的变化频率的比较.
- 对NGS分析物和临床病理共变量进行统计调整;生存分析.
主要成果:
- 虽然顶部改变的基因相似,但频率因种族/种族而异.
- 非西班牙裔黑人退伍军人显示,SPOP和免疫治疗目标 (例如MSI高) 的变化几率更高.
- 在非西班牙裔黑人退伍军人中,在AKT/PI3K通路,雄激素受体轴和瘤抑制基因中观察到更低的变化几率.
- 瘤抑制基因 (例如TP53) 的改变与两组患者的生存时间缩短有关.
结论:
- 在mPCa.种族群体之间存在基因组改变频率的显著差异.
- 基因组测试的实用性被证实用于识别准确瘤学候选人,不论种族.
- 解决这些差异可以有助于更公平的前列腺癌护理结果.
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