演題抄録

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開催概要
開催回
第58回・2020年・京都
 

がんゲノム医療におけるリキッドバイオプシーの臨床的有用性の検討

演題番号 : WS12-4

[筆頭演者]
松寺 翔太郎:1,2,3 
[共同演者]
加納 嘉人:1、青柳 康子:1、遠山 皓基:1、木村 浩一朗:4、大西 威一郎:5、竹本 暁:6、荻野 恵:2、岡本 健太郎:2、植竹 宏之:2、田邉 稔:7、三宅 智:8、土岡 丘:3、小嶋 一幸:3、池田 貞勝:1

1:東京医科歯科大学附属病院・がんゲノム診療科、2:東京医科歯科大学附属病院・総合外科、3:獨協医科大学病院・第一外科、4:東京医科歯科大学附属病院・放射線科、5:東京医科歯科大学附属病院・病理部、6:東京医科歯科大学附属病院・バイオリソースセンター、7:東京医科歯科大学附属病院・肝胆膵外科、8:東京医科歯科大学附属病院・がん先端治療部

 

Clinical utility of plasma cell-free DNA for precision cancer medicine has not been established. We conducted a pilot study to investigate the clinical utility of comprehensive genomic profiling by liquid biopsy in Japanese population. In PROFILE study, 102 cases with advanced solid tumor who progressed with or were progressing with standard systemic therapy underwent liquid biopsy between August 2017 and February 2020. Liquid biopsy was performed using Guardant360 (Guardant Health, Inc.). Of 102 patients, 56 were female, and median age was 65 years old. As for the types of cancer, 31 (30.3%) were hepatobiliary and pancreatic cancer, 17 (16.6%) were gastrointestinal cancer, and 13 (12.7%) were breast cancer. Frequently altered genes were TP53 (53.9%), KRAS (25.5%), PIK3CA (19.6%), and EGFR (17.6%). At least one genetic aberration was detected in 91 patients (89.2%). Actionable mutation was discovered in 89 patients (87.3%) and 68 patients (66.7%) had clinical trial candidates. 23 patients (22.5%) were able to receive biomarker-matched therapy. Their best responses were 1 complete response (CR), 3 partial response (PR), 8 stable disease (SD), 11 progressive disease (PD), respectively. Additionally, we focused on response by matching score, which was initially described by Sicklick and colleagues. Matching score represents how many genomic alterations was targeted by alteration-matched molecular targeted therapy. We divided patients treated based on matching scores ≧50% versus <50%. When patients were stratified to high and low groups, disease control rate (DCR) was significantly improved in the high group (75.0%) compared with the low group (27.3%) (p=0.022).
This study showed the clinical utility of comprehensive genomic profiling in plasma cell-free DNA in Japanese population. Further study of clinical utility of liquid biopsy may open the path toward novel therapeutic strategies in the future.

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臓器別:その他

手法別:ゲノム・遺伝子

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