在胰腺癌中可操作的突变:有针对性的疗法正在改变的地方
Morgan Fivaz1, Aurélie Bornand2, Claudia Corro1,3
1Oncology Department, Geneva University Hospital, Geneva, Switzerland.
BMJ open gastroenterology
|November 27, 2025
概括
在胰腺癌中准罕见的基因变异是有希望的,提供与标准化疗相比的生存益处. 综合的基因组测序对于在晚期胰腺管道腺癌中识别这些可操作的标至关重要.
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:
- 在一线化疗失败后,胰腺管道腺癌 (PDAC) 的预后不好,治疗选择有限.
- 虽然KRAS突变很常见,但其他治疗可行的改变越来越多地被确定.
研究的目的:
- 审查针对PDAC的向治疗的I-II期试验的证据.
- 评估针对PDAC罕见遗传变化的疗效和毒性.
主要方法:
- 系统审查到2025年4月发表的I-II期临床试验.
- 对各种向药物的结果分析,包括总生存率,无进展生存率和客观反应率.
主要成果:
- 向疗法达到或超过NAPOLI-1试验基准 (mOS 6.2个月,mPFS 3.1个月).
- 特定药物显示高响应率:阿达格拉西布 (33%在KRAS G12C中),奥拉帕里布 (22%在BRCA1/2),RET/NTRK抑制剂 (>50%),布罗利祖马布 (MSI-H/dMMR).
- 新兴的目标包括NRG1融合,HER2放大,MTAP删除和泛RAS抑制剂.
结论:
- 向性药物提供了有利的毒性概况,并允许与化疗相比长期使用.
- 全面的下一代测序对于确定可操作的目标和推动PDAC向精确瘤学发展至关重要.
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