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CLIN CANCER RES:肺大细胞神经内分泌癌分子亚型可预测化疗反应

2018-01-08 MedSci MedSci原创

大细胞神经内分泌癌是肺癌中一种罕见的亚型,其合理的治疗方案尚存在争议。之前的遗传学研究发现了两类不同的大细胞神经内分泌癌(LCNEC)分子亚型:RB1突变型(通常存在TP53共突变)和RB1野生型。CLIN CANCER RES近期发表了一篇文章,研究这类分子亚型是否对化疗结果由预测价值。

大细胞神经内分泌癌是肺癌中一种罕见的亚型,其合理的治疗方案尚存在争议。之前的遗传学研究发现了两类不同的大细胞神经内分泌癌(LCNEC)分子亚型:RB1突变型(通常存在TP53共突变)和RB1野生型。CLIN CANCER RES近期发表了一篇文章,研究这类分子亚型是否对化疗结果由预测价值。

作者回顾性收集了临床数据和肿瘤标本。通过病理在232例患者中确诊了148例LCNEC患者。在79例患者中进行了TP53,RB1,STK11,KEAP1基因的二代基因测序,在109例患者中使用免疫组化检测了RB1和P16,并将结果与总生存和无进展生存相联系,并根据不同治疗策略进行分层。治疗策略有铂类+吉西他滨或紫杉烷(NSCLC-GEM/TAX)和铂类-依托泊苷(SCLC-PE)两种。研究结果发现,在47%的患者中发现RB1突变,在72%的患者中发现RB1蛋白缺失。对RB1野生型LCNEC患者,接受NSCLC-GEM/TAX化疗的总生存显着优于接受SCLC-PE化疗的患者。在表达RB1蛋白的患者中观察到了相似的结果。RB1染色或P16缺失也有相似结果。在RB1突变或缺失RB1蛋白的LCNEC患者中化疗结果相同。

文章最后认为,携带野生型RB1基因或表达RB1蛋白的LCNEC肿瘤患者进行NSCLC-GEM/TAX治疗效果优于SCLC-PE化疗。但是RB1突变或蛋白表达缺失的患者中两种方案并无区别。

原始出处:
Jules L.Derks,Noemie Leblay,et al.Molecular Subtypes of Pulmonary Large-cell Neuroendocrine Carcinoma Predict Chemotherapy Treatment Outcome.CLIN CANCER RES.January 2018 doi:10.1158/1078-0432.CCR-17-1921

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    2018-02-24 gwc392
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    2018-01-14 jyzxjiangqin

    肺大细胞神经内分泌.

    0

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    2018-01-08 131****1460

    学习了受益匪浅

    0

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