对lirafugratinib的复发性耐药性突变在FGFR2驱动的瘤中告知了治疗序列
Francesco Facchinetti1, Antoine Hollebecque2, Rémy Barbé2
1Institut Gustave Roussy Paris France.
概括
连续使用不可逆转的FGFR抑制剂lirafugratinib和futibatinib可以克服耐药性突变. 这一策略在治疗FGFR2驱动的癌症方面是有前途的,尤其是在初始治疗失败后.
科学领域:
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
- 遗传学 遗传学 是一个
背景情况:
- 可逆FGFR抑制剂可能会导致"不可抗药"的FGFR2突变,限制癌症治疗选择.
- 不可逆转的FGFR抑制剂lirafugratinib和futibatinib在FGFR2驱动的瘤中显示出临床前景.
研究的目的:
- 在患有FGFR2驱动癌症的患者中对lirafugratinib的耐药性机制的特征.
- 评估使用lirafugratinib和futibatinib连续治疗的可能性.
主要方法:
- 对来自ReFocus试验的30名患者的循环瘤DNA (ctDNA) 和组织测序的分析.
- 在Ba/F3模型和使用患者衍生异体移植的体内研究中进行活力测定.
主要成果:
- 对lirafugratinib获得的耐药性涉及新的FGFR2突变 (M538,L618).
- 与futibatinib耐药性相比,FGFR2分子制动 (N550) 和守门员 (V565) 突变是罕见的.
- 在lirafugratinib进展后,随着futubatinib的连续治疗导致了三名患者的长时间反应.
结论:
- 利拉弗格拉提尼布和费图巴提尼布对FGFR2突变表现出相辅相成的活性.
- 顺序给予得到了观察到的耐药性模式和临床结果的支持.
- 检测特定的耐药性突变指导着这些不可逆转的FGFR抑制剂的顺序使用.
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