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J-GLOBAL ID：202002217514526703   整理番号：20A2659225

ゲフィチニブ治療下の進行EGFR変異肺腺癌におけるベースライン随伴突然変異と縦循環腫瘍DNAモニタリングに基づく精製層化【JST・京大機械翻訳】

Refined Stratification Based on Baseline Concomitant Mutations and Longitudinal Circulating Tumor DNA Monitoring in Advanced EGFR-Mutant Lung Adenocarcinoma Under Gefitinib Treatment

著者 (29件)： Duan Jianchun (State Key Laboratory of Molecular Oncology, Department of Medical Oncology, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China) ,  Xu JiaChen (State Key Laboratory of Molecular Oncology, Department of Medical Oncology, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China) ,  Wang Zhijie (State Key Laboratory of Molecular Oncology, Department of Medical Oncology, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China) ,  Bai Hua (State Key Laboratory of Molecular Oncology, Department of Medical Oncology, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China) ,  Cheng Ying (Division of Thoracic Oncology, Jilin Cancer Hospital, Jilin Province Cancer Hospital, Changchun, People’s Republic of China) ,  An Tongtong (Department of Thoracic Medical Oncology, Peking University School of Oncology, Beijing Cancer Hospital and Institute, Beijing, People’s Republic of China) ,  Gao Hongjun (The 307th Hospital of Chinese People’s Liberation Army, Beijing, People’s Republic of China) ,  Wang Kai (Department of Respiratory Medicine, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, People’s Republic of China) ,  Zhou Qing (Guangdong Lung Cancer Institute, Guangdong Provincial People’s Hospital and Guangdong Academy of Medical Sciences, Guangzhou, People’s Republic of China) ,  Hu Yanping (Department of Oncology, Hubei Cancer Hospital, Hubei, People’s Republic of China) ,  Song Yong (Nanjing General Hospital of Nanjing Military Command and PLA Bayi Hospital, Nanjing, People’s Republic of China) ,  Ding Cuimin (Department of Respiratory Medicine, The Fourth Hospital of Hebei Medical University, Hebei, People’s Republic of China) ,  Peng Feng (Department of Thoracic Oncology, Cancer Center, West China Hospital, Medical School, Sichuan University, Chengdu, People’s Republic of China) ,  Liang Li (Peking University Third Hospital, Beijing, People’s Republic of China) ,  Hu Yi (Chinese People’s Liberation Army General Hospital, Beijing, People’s Republic of China) ,  Huang Cheng (Department of Medical Oncology, Fujian Provincial Cancer Hospital, Teaching Hospital of Fujian University of Traditional Chinese Medicine, Teaching Hospital of Fujian Medical University, Fuzhou, People’s Republic of China) ,  Zhou Caicun (Shanghai Pulmonary Hospital, Tongji University, Shanghai, People’s Republic of China) ,  Shi Yuankai (State Key Laboratory of Molecular Oncology, Department of Medical Oncology, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China) ,  Han Jiefei (State Key Laboratory of Molecular Oncology, Department of Medical Oncology, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China) ,  Wang Di (State Key Laboratory of Molecular Oncology, Department of Medical Oncology, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China) ,  Tian Yanhua (State Key Laboratory of Molecular Oncology, Department of Medical Oncology, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China) ,  Yang Zhenlin (Department of Thoracic Surgery, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China) ,  Zhang Li (Sun Yat-sen University Cancer Center, Guangzhou, People’s Republic of China) ,  Chuai Shaokun (Burning Rock Biotech, Guangdong, People’s Republic of China) ,  Ye Junyi (Burning Rock Biotech, Guangdong, People’s Republic of China) ,  Zhu Guanshan (Amoy Diagnostics, Xiamen, People’s Republic of China) ,  Zhao Junhui (Department of Medical Oncology, Affiliated Hospital of Qinghai University, Qinghai, People’s Republic of China) ,  Wu Yi-long (Guangdong Lung Cancer Institute, Guangdong Provincial People’s Hospital and Guangdong Academy of Medical Sciences, Guangzhou, People’s Republic of China) ,  Wang Jie (State Key Laboratory of Molecular Oncology, Department of Medical Oncology, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China)
資料名： Journal of Thoracic Oncology  (Journal of Thoracic Oncology)
巻： 15  号： 12  ページ： 1857-1870  発行年： 2020年 
JST資料番号： W3145A  ISSN： 1556-0864  資料種別： 逐次刊行物 (A)
記事区分： 原著論文  発行国： オランダ (NLD)  言語： 英語 (EN)

抄録/ポイント： EGFR変異型肺腺癌(LUAD)の最適治療は,腫瘍内不均一性のため困難である。循環腫瘍DNA(ctDNA)追跡の総合分析に基づく精製層化モデルを,ベースラインで前向きに収集し,第2相試験に登録されたゲフィチニブ治療下の進行治療未治療EGFR変異LUAD患者の8週毎に前向きに収集し,168遺伝子パネルの次世代配列決定を用いて分析した。ベースライン共変異-EGFR感作変異(59,32.8%),腫瘍サプレッサー変異を伴うEGFR感作変異(97,53.9%),および他のドライバー変異(24,13.3%)によるEGFR感作変異により分類された3つのサブグループは,初期層別化に対する証拠を提供し,それぞれ,異なる無増悪生存(13.2[11.3-15.2]対9.3[7.6-10.5]対4.0[2.4-9.3]か月)および全生存(32.0[29.2-41.5]対21.7[19.3-27.0]対15.5[10.5-33.7]か月)を示した。患者の合計63.7%は,週8ctDNAクリアランスを達成し,有意差は3つの亜群(それぞれ74.5%対64.0%対29.4%,p=0.004,フィッシャーの正確試験)の間で認められた。週8のctDNAクリアランスのない患者は,特に第2のサブグループ[5.8(5.6-11.5)か月]で,より悪い無増悪生存率(クリアランス対非クリアランス11.2[9.9-13.2]対7.4[5.6-9.6]か月,p=0.016,Cox回帰),特に第2亜群[5.8(5.6-11.5)か月]で,治療中の適応層化の必要性を示唆した。追跡調査の間,患者の56.0%と20.8%は,最終的にp.T790Mと非pであった。T790M変異は,それぞれ,非pで有意差があった。3つのサブグループ間のT790M突然変異(それぞれ7.5%対15.7%対80.0%,p<0.001,フィッシャーの正確検定)は,ポストライン治療の手がかりを与えた。ベースライン共変異と最初の訪問でのctDNA非クリアランスを有する患者は,EGFRチロシンキナーゼ阻害剤単剤療法の限られた生存利点のため,併用療法を必要とする可能性がある。EGFR変異LUADの全コース管理のための精製層化モードを提案した。Copyright 2020 Elsevier B.V., Amsterdam. All rights reserved. Translated from English into Japanese by JST.【JST・京大機械翻訳】

シソーラス用語： 遺伝子 ,  感作 ,  クリアランス ,  *腫瘍 ,  *突然変異 ,  層別 ,  併用療法 ,  成層 ,  基準線 ,  *EGF受容体 ,  第二相試験
準シソーラス用語： *肺腺癌 ,  無増悪生存期間 ,  EGFRチロシンキナーゼ阻害剤 ,  無増悪生存率 , 【Automatic Indexing@JST】

著者キーワード (5件)： 肺腺癌 ,  上皮増殖因子受容体 ,  共突然変異 ,  精製層化 ,  ctDNAモニタリング

分類 (1件)： 呼吸器の腫よう  (GI04000G)

タイトルに関連する用語 (13件)： ゲフィチニブ ,  治療 ,  EGFR ,  変異 ,  肺腺癌 ,  ベースライン ,  随伴 ,  突然変異 ,  縦 ,  循環腫瘍DNA ,  モニタリング ,  精製 ,  層化