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JAMA:在肺癌中用致癌驱动基因多重检测法来选择靶向药物

2014-06-16 马克·G ·克里斯等 中国医学论坛报JAMA专版

意义:致癌驱动基因是癌症发生与维持很重要的基因组改变,致癌驱动基因靶向疗法改变了肺腺癌患者的治疗。肺癌突变联盟(LCMC)成立,通过采用多重检测法从10个基因中检测肺腺癌的驱动基因,以便临床医师能够选择靶向治疗,并在临床试验中纳入患者。  目的:在肺腺癌患者中确定致癌驱动基因(出现)的频率,应用该数据来选择以识别出的驱动基因为靶标的治疗方法,并对生存期进行检测。  设计、场

意义:致癌驱动基因是癌症发生与维持很重要的基因组改变,致癌驱动基因靶向疗法改变了肺腺癌患者的治疗。肺癌突变联盟(LCMC)成立,通过采用多重检测法从10个基因中检测肺腺癌的驱动基因,以便临床医师能够选择靶向治疗,并在临床试验中纳入患者。【原文下载】  目的:在肺腺癌患者中确定致癌驱动基因(出现)的频率,应用该数据来选择以识别出的驱动基因为靶标的治疗方法,并对生存期进行检测。  设计、场所和参与者:2009-2012年期间,从美国14个研究机构纳入患有转移性肺腺癌的患者,这些患者的体能状态评分为0~2分,并检测其肿瘤样本中是否存在10个驱动基因。收集患者、治疗方式和生存期信息。  干预措施:在肿瘤标本中对10个驱动基因进行检测,并将结果用于选择匹配的靶向治疗。  主要转归和检测指标:确定致癌驱动基因(出现)的频率、采用以基因型为导向治疗的患者比例及生存期。  结果:2009-2012年期间,对来自1007例患者的肿瘤样本进行了至少1种(驱动)基因的检测,对733例患者的肿瘤样本中进行了10种驱动基因检测(全基因分型患者)。在733例患者中

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  1. [GetPortalCommentsPageByObjectIdResponse(id=42958, encodeId=53844295858, content=翻译得不错!, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e3251649506, createdName=小果, createdTime=Tue Nov 10 19:49:00 CST 2015, time=2015-11-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2079986, encodeId=e14b20e998667, content=<a href='/topic/show?id=e2b286520e4' target=_blank style='color:#2F92EE;'>#致癌驱动#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=86520, encryptionId=e2b286520e4, topicName=致癌驱动)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=80ca273, createdName=fanweitanzhen, createdTime=Wed Sep 10 02:18:00 CST 2014, time=2014-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1661475, encodeId=9a2416614e5da, content=<a href='/topic/show?id=34a110150800' target=_blank style='color:#2F92EE;'>#驱动基因#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101508, encryptionId=34a110150800, topicName=驱动基因)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b94625296381, createdName=751943081_32627957, createdTime=Mon Dec 22 22:18:00 CST 2014, time=2014-12-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=9994, encodeId=c6289994df, content=有全文翻译吗, beContent=null, objectType=article, channel=null, level=null, likeNumber=218, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aadc104177, createdName=lch19850115, createdTime=Wed Jun 18 22:22:00 CST 2014, time=2014-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1370801, encodeId=01ca13e0801f8, content=<a href='/topic/show?id=9c39864991e' target=_blank style='color:#2F92EE;'>#致癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=86499, encryptionId=9c39864991e, topicName=致癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2c25323, createdName=jambiya, createdTime=Wed Jun 18 04:18:00 CST 2014, time=2014-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=9938, encodeId=0536993872, content=内容很详实, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=006098398, createdName=taotaoyanan, createdTime=Mon Jun 16 18:39:00 CST 2014, time=2014-06-16, status=1, ipAttribution=)]
    2015-11-10 小果

    翻译得不错!

    0

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  4. [GetPortalCommentsPageByObjectIdResponse(id=42958, encodeId=53844295858, content=翻译得不错!, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e3251649506, createdName=小果, createdTime=Tue Nov 10 19:49:00 CST 2015, time=2015-11-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2079986, encodeId=e14b20e998667, content=<a href='/topic/show?id=e2b286520e4' target=_blank style='color:#2F92EE;'>#致癌驱动#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=86520, encryptionId=e2b286520e4, topicName=致癌驱动)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=80ca273, createdName=fanweitanzhen, createdTime=Wed Sep 10 02:18:00 CST 2014, time=2014-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1661475, encodeId=9a2416614e5da, content=<a href='/topic/show?id=34a110150800' target=_blank style='color:#2F92EE;'>#驱动基因#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101508, encryptionId=34a110150800, topicName=驱动基因)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b94625296381, createdName=751943081_32627957, createdTime=Mon Dec 22 22:18:00 CST 2014, time=2014-12-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=9994, encodeId=c6289994df, content=有全文翻译吗, beContent=null, objectType=article, channel=null, level=null, likeNumber=218, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aadc104177, createdName=lch19850115, createdTime=Wed Jun 18 22:22:00 CST 2014, time=2014-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1370801, encodeId=01ca13e0801f8, content=<a href='/topic/show?id=9c39864991e' target=_blank style='color:#2F92EE;'>#致癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=86499, encryptionId=9c39864991e, topicName=致癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2c25323, createdName=jambiya, createdTime=Wed Jun 18 04:18:00 CST 2014, time=2014-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=9938, encodeId=0536993872, content=内容很详实, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=006098398, createdName=taotaoyanan, createdTime=Mon Jun 16 18:39:00 CST 2014, time=2014-06-16, status=1, ipAttribution=)]
    2014-06-18 lch19850115

    有全文翻译吗

    0

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    2014-06-18 jambiya
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    2014-06-16 taotaoyanan

    内容很详实

    0

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5月21日在线发表于《美国医学会杂志》上的一项研究显示,对肺癌肿瘤的多重基因检测有助于选择靶向治疗的基因异常。与那些没有接受导向性治疗的患者相比,接受肺癌匹配疗法的患者生存期会更长,然而,还需要随机化临床试验来验证这一治疗策略是否能提高患者的生存率。靶向治疗的引入已经通过将肿瘤基因分型与治疗决策相整合,从而改变了肺癌治疗的局面。腺癌是最常见的肺癌类型;美国每年有13万人被诊断为肺腺癌,而全世界则每

JTO:小于3cm肺腺癌实性成分的大小与淋巴结转移相关

肿瘤大小和淋巴结状态被认为是肿瘤淋巴结转移分级系统(TNM)的基本因素。一般而言,实体瘤包括肺癌的大小淋巴结转移相关。然而,肿瘤大小和淋巴结转移之间的相关性也非存在于所有类型肺癌。研究报道较小的鳞癌肿块与淋巴结转移无明显相关,然而小的腺癌肿块与淋巴结转移之间具有相关性。常规体检和CT扫描发现肺癌患者的数目不断增加。通过CT扫描发现外周小肺癌,病理表现主要为腺癌,特别是原位癌。肺癌的病理学特征和预测

局部晚期NSCLC化放疗研究进展

对不可手术的Ⅲ期NSCLC患者,一般推荐行同期化放疗,化放疗后巩固化疗的效果仍不清楚。该项多中心Ⅲ期随机试验的目的是确定不可手术的Ⅲ期NSCLC多西他赛+顺铂化疗同期根治性放疗后予相同方案巩固化疗的临床结果。 N2、N3分期通过正电子发射体层摄影(PET)和(或)病理学确认。符合条件的患者随机接受单纯同期化放疗或同期化放疗+多西他赛+顺铂巩固化疗。在同期化放疗的6周时间内,多西他赛和顺铂剂量均为

JCO述评:肺癌临床管理的进展

肺癌新药:血管生成抑制剂抑制血管生成的途径主要有两种,分别为可靶向作用于配体、受体的单克隆抗体,以及小分子血管内皮生长因子受体酪氨酸激酶抑制剂(TKIs)。一项II期随机试验显示,使用贝伐单抗加紫杉醇/卡铂治疗非小细胞肺癌患者其生存期优于紫杉醇/卡铂单一治疗。然而,值得注意的是鳞癌患者往往出血过多,阻止了贝伐单抗在这一亚组中的进一步研究。该项II期试验推动美国东部肿瘤协作组开展了一项III期试

Nat Genet:携带BRCA2突变的吸烟者更易患上肺癌

最近的一项新研究证实,BRCA2和CHEK2基因变异,特别是突变型BRCA2,可以大大增加个人患肺癌的风险。如果吸烟者携带BRCA2变异,其患肺癌的风险可能翻倍。 由伦敦癌症研究所、法国国际癌症研究机构、美国国家癌症研究所和美国达特茅斯学院等研究结构组成的国际合作小组,利用来自1000个肺癌遗传学研究基因组项目的综合结果,完成了这一研究,相关结果发表在2014年6月1日的《自然遗传学》(Natu

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