弥合差距:ctDNA,基因组学,以及乳腺癌护理中的公平
Julia Aronson1, Manasa Bhatta1, Lisa A Carey1
1Department of Medicine, Division of Oncology, UNC Chapel Hill, Chapel Hill, NC, USA.
NPJ breast cancer
|August 16, 2025
概括
循环瘤DNA (ctDNA) 提供非侵入性癌症监测,但在不同人群中在获取和应用方面存在差异. 解决这些不平等问题对于乳腺癌护理中公平的精确瘤学至关重要.
科学领域:
- 在瘤学瘤学.
- 基因组学就是基因组学.
- 健康 公平 卫生 公平
背景情况:
- 循环瘤DNA (ctDNA) 是用于精确瘤学的非侵入性工具,有助于瘤分析,最小残留疾病 (MRD) 检测和乳腺癌治疗监测.
- 尽管它在转移性和早期乳腺癌中的承诺,但ctDNA的好处并没有在所有患者群体中均分布.
研究的目的:
- 审查目前关于ctDNA检测,测试性能和在种族,种族和地理代表性不足的人群中的临床实用性的证据.
- 鉴定ctDNA利用和获得基因型匹配疗法的差异,考虑结构性障碍和全球实施挑战.
主要方法:
- 来自基因组研究,基于ctDNA的临床试验和实施研究的综合数据.
- 研究了ctDNA水平,突变概况,测试利用率和获得向治疗的差异.
- 整合全球数据,包括来自低收入和中等收入国家,关于ctDNA实施可行性和挑战.
主要成果:
- 在代表性不足的人群中,确定了ctDNA测试利用率和获得基因型匹配疗法的显著差异.
- 突出结构性障碍,包括保险覆盖,地理位置,临床研究中的代表性不足等.
- 证实了ctDNA在全球资源有限的环境中实施的可行性,但也存在挑战.
结论:
- 在不同环境中,ctDNA具有个性化乳腺癌护理的巨大潜力.
- 迫切需要将公平纳入ctDNA验证,临床应用和政策制定,以防止加剧现有的健康差异.
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