小柯机器人

日本国立癌症中心医院Takayuki Yoshino团队取得一项新突破。他们总结了循环肿瘤DNA（ctDNA）测序在晚期胃肠道癌中的临床应用。这一研究成果发表在2020年10月5日出版的国际学术期刊《自然-医学》上。

为了评估ctDNA基因分型的效用，他们使用在SCRUM-Japan GOZILA（编号UMIN000016343）中进行的1687名晚期胃肠道（GI）癌症患者ctDNA测序，对试验入组进行比较，这是一项基于ctDNA的观察性研究，使用相同组织和网络中的肿瘤组织测序进行招募（GI-SCREEN，5,621名患者）。

与组织基因分型相比，ctDNA基因分型显著缩短了筛选时间（11天比33天，P <0.0001），提高了试验入组率（9.5％对4.1％，P <0.0001），而没有损害治疗功效。

他们还描述了约2,000名晚期GI癌症患者的ctDNA图谱的克隆结构，这加强了许多可靶向的致癌驱动因素的相关性，并强调了多种新的驱动因素可作为临床开发的候选药物。ctDNA基因分型有可能加速精准医学的创新及其向个别患者的交付。

据了解，全面的基因组分析可在晚期实体瘤中检测基因组生物标记。

附：英文原文

Title: Clinical utility of circulating tumor DNA sequencing in advanced gastrointestinal cancer: SCRUM-Japan GI-SCREEN and GOZILA studies

Author: Yoshiaki Nakamura, Hiroya Taniguchi, Masafumi Ikeda, Hideaki Bando, Ken Kato, Chigusa Morizane, Taito Esaki, Yoshito Komatsu, Yasuyuki Kawamoto, Naoki Takahashi, Makoto Ueno, Yoshinori Kagawa, Tomohiro Nishina, Takeshi Kato, Yoshiyuki Yamamoto, Junji Furuse, Tadamichi Denda, Hisato Kawakami, Eiji Oki, Takako Nakajima, Naohiro Nishida, Kensei Yamaguchi, Hisateru Yasui, Masahiro Goto, Nobuhisa Matsuhashi, Koushiro Ohtsubo, Kentaro Yamazaki, Akihito Tsuji, Wataru Okamoto, Katsuya Tsuchihara, Takeharu Yamanaka, Izumi Miki, Yasutoshi Sakamoto, Hiroko Ichiki, Masayuki Hata, Riu Yamashita, Atsushi Ohtsu, Justin I. Odegaard, Takayuki Yoshino

Issue&Volume: 2020-10-05

Abstract: Comprehensive genomic profiling enables genomic biomarker detection in advanced solid tumors. Here, to evaluate the utility of circulating tumor DNA (ctDNA) genotyping, we compare trial enrollment using ctDNA sequencing in 1,687patients with advanced gastrointestinal (GI) cancer in SCRUM-Japan GOZILA (no. UMIN000016343), an observational ctDNA-based screening study, to enrollment using tumor tissue sequencing in the same centers and network (GI-SCREEN, 5,621patients). ctDNA genotyping significantly shortened the screening duration (11 versus 33days, P<0.0001) and improved the trial enrollment rate (9.5 versus 4.1%, P<0.0001) without compromising treatment efficacy compared to tissue genotyping. We also describe the clonal architecture of ctDNA profiles in ~2,000patients with advanced GI cancer, which reinforces the relevance of many targetable oncogenic drivers and highlights multiple new drivers as candidates for clinical development. ctDNA genotyping has the potential to accelerate innovation in precision medicine and its delivery to individual patients.

DOI: 10.1038/s41591-020-1063-5

Source: https://www.nature.com/articles/s41591-020-1063-5

Nature Medicine：《自然—医学》，创刊于1995年。隶属于施普林格·自然出版集团，最新IF：87.241
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