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CLIN CANCER RES:HER-2阳性转移性胃癌曲妥珠单抗原发耐药的生物学标志

2018-03-07 MedSci MedSci原创

如何选择合适的HER2阳性转移性胃癌患者进行曲妥珠单抗治疗是精准医学的一大挑战。临床前研究发现了几种原发耐药的遗传机制,会导致酪氨酸激酶受体活化而非HER2或下游信号通路活化

如何选择合适的HER2阳性转移性胃癌患者进行曲妥珠单抗治疗是精准医学的一大挑战。临床前研究发现了几种原发耐药的遗传机制,会导致酪氨酸激酶受体活化而非HER2或下游信号通路活化。

作者进行了多中心,前瞻性病例对照研究一系列基因改变(AMNESIA panel)的预测效果,包括EGFR/MET/KRAS/PI3K/PTEN突变和EGFR/MET/KRAS扩增。设定HER2-阳性耐药患者目标突变达到30%,敏感患者突变为0%,每组需要20例患者。研究结果表明,与敏感患者相比,耐药患者AMNESIA panel突变频率更高,HER2 IHC2+的肿瘤突变频率高于HER2 IHC3+的肿瘤。不携带突变的肿瘤患者中位无进展生存和总生存情况更佳。AMNESIA panel和HER2 IHC预测准确性分别为76%和65%。AMNESIA panel联合HER2 IHC预测准确性为84%。

文章最后认为,这些基因突变在预测HER2阳性转移性胃癌患者曲妥珠单抗原发耐药方面具有一定的临床作用,需要进一步对HER2相关肿瘤进行分子分类已寻找更有效的治疗策略。

原始出处:
Filippo Pietrantonio,Giovanni Fuca,et al.Biomarkers of Primary Resistance to Trastuzumab in HER2-Positive Metastatic Gastric Cancer Patients:the AMNESIA Case-Control Study.CLIN CANCER RES.March 2018 doi:10.1158/1078-0432.CCR-17-2781

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    2018-03-15 大爰

    学习了谢谢分享!!

    0

  5. 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authenticateStatus=null, createdAvatar=null, createdBy=f59b20519025, createdName=xiaoyeshuang, createdTime=Fri Mar 09 05:32:00 CST 2018, time=2018-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=293893, encodeId=1a0d293893d5, content=学习了.涨知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Wed Mar 07 17:26:01 CST 2018, time=2018-03-07, status=1, ipAttribution=)]
    2018-03-09 清风拂面

    谢谢分享学习

    0

  6. 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    2018-03-09 zhu_jun9840
  8. 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    2018-03-07 1ddf0692m34(暂无匿称)

    学习了.涨知识

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