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与1级BRAF突变癌症相比,患有2级或3级BRAF的患者的真实世界发生,治疗和结局
S Pradervand1, N Freundler1, B Gosztonyi2
1Centre Hospitalier Universitaire Vaudois - CHUV, Department of Oncology, Lausanne.
概括
非V600 BRAF突变带来了治疗挑战. 虽然整体存活率相似,但非V600 BRAF突变癌症在使用 BRAF/MEK 抑制剂时的无进展存活率较低,尽管一些突变可能会产生反应.
科学领域:
- 在瘤学瘤学.
- 遗传学 是一个遗传学.
- 药理学 药理学是指药理学的学科.
背景情况:
- BRAF V600突变是癌症治疗的既定目标.
- 关于非V600 BRAF突变的临床影响的了解有限.
- 使用瑞士个性化瘤学数据基础设施,本研究将非V600 BRAF突变患者的结果与1类突变进行比较.
研究的目的:
- 评估非V600 BRAF突变患者的临床结果.
- 为了比较BRAF/MEK抑制剂在具有不同BRAF突变类别的患者中的疗效.
- 为了确定非V600 BRAF突变癌症的潜在治疗策略.
主要方法:
- 追溯观察多中心研究.
- 392名患有第1类BRAF突变的患者和154名患有非第1类BRAF突变的患者.
- 基于突变类和治疗小组的总生存 (OS) 和无进展生存 (PFS) 的分析.
主要成果:
- 1类和非1类BRAF突变组之间的OS没有显著差异.
- 在第1类突变黑色素瘤 (217天) 和非第1类 (73天) 中,BRAF/MEK 抑制剂在数值上显示了更长的PFS.
- 对于第2或第3类突变,BRAF/MEK 抑制剂与其他疗法相比没有显著的益处,除了像K601E.这样的特定突变.
结论:
- 非1类BRAF突变带来了治疗挑战,在BRAF/MEK封锁下,尽管存在类似的OS,但PFS趋势较低.
- 特定的非1类突变,如2类K601E,可能表明对BRAF/MEK抑制剂的敏感性.
- 在治疗非1类BRAF突变瘤时,需要采用突变特异的,而不是类特异的方法.
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