【佳學(xué)基因靶向藥物基因檢測(cè)】奧希替尼對(duì)攜帶原發(fā)性 EGFR-T790M 突變的肺腺癌肺段切除術(shù)后對(duì)側(cè)多發(fā)磨玻璃結(jié)節(jié)有效

國內(nèi)腫瘤檢測(cè)指標(biāo)機(jī)構(gòu)排行榜加密

這的藥物化治療及藥物選擇聽到《J Cardiothorac Surg》在 2022 Dec 19;17(1):324.發(fā)表了一篇題目為《Osimertinib showed efficacy on contralateral multiple ground-glass nodules after segmentectomy for lung adenocarcinoma harboring primary EGFR-T790M mutation: a case report and review of the literature》腫瘤靶向藥物治療基因檢測(cè)臨床研究文章。該研究由Haijun Dong, Jianbin Zhang, Weiwei Min, Qibin Shen等完成。促進(jìn)了腫瘤的正確治療與個(gè)性化用藥的發(fā)展，進(jìn)一步強(qiáng)調(diào)了基因信息檢測(cè)與分析的重要性。這項(xiàng)研究報(bào)告了一個(gè)多發(fā)磨玻璃樣結(jié)節(jié)(mGGNs)合并原發(fā)EGFR T790M突變肺腺癌的病例,其對(duì)腫瘤診斷和治療有以下幾點(diǎn)啟示: 對(duì)于mGGNs的鑒別診斷具有參考價(jià)值,提醒需要與原發(fā)多發(fā)肺癌進(jìn)行鑒別,結(jié)合病理和分子檢測(cè)進(jìn)行確認(rèn)。 對(duì)EGFR T790M突變陽性的肺腺癌患者,手術(shù)切除可能是賊佳治療選擇。 對(duì)于殘余mGGNs,可以繼續(xù)采用Osimertinib等EGFR-TKI目標(biāo)治療。 不同病灶對(duì)EGFR-TKI治療反應(yīng)存在異質(zhì)性,提示存在克隆進(jìn)化或耐藥機(jī)制。 EGFR-TKI可作為mGGNs術(shù)后殘余病灶的有效治療手段,但需要進(jìn)一步優(yōu)化治療策略。 該研究支持對(duì)肺癌進(jìn)行基因檢測(cè)指導(dǎo)正確用藥的重要性,EGFR狀態(tài)預(yù)測(cè)EGFR-TKI療效。 總之,該研究通過一個(gè)典型病例闡明了EGFR突變陽性肺癌正確診治策略,也提出了mGGNs個(gè)體化治療的參考方案,對(duì)這類患者的臨床管理具有一定的指導(dǎo)意義。

腫瘤基因檢測(cè)及靶向藥物治療研究關(guān)鍵詞：

表皮生長因子受體酪氨酸激酶抑制劑 (EGFR-TKI),多發(fā)磨玻璃結(jié)節(jié) (mGGNs),同步多原發(fā)性肺癌 (SMPLC)。

腫瘤治療檢測(cè)基因臨床應(yīng)用結(jié)果

靶向藥物研究立項(xiàng)的依據(jù)：肺部多發(fā)磨玻璃結(jié)節(jié)（mGGNs）已被定義為同時(shí)性多原發(fā)性肺癌（SMPLC），SMPLC與肺內(nèi)轉(zhuǎn)移瘤的鑒別難度很大，其治療仍存在爭議。病例介紹：我們報(bào)道一例mGGNs與原發(fā)性EGFR-T790M突變肺腺癌同時(shí)發(fā)生，患者行左上肺病灶治好性切除，右肺各葉殘留mGGNs繼續(xù)奧希替尼治療。這些 mGGNs 對(duì)奧希替尼表現(xiàn)出不同的反應(yīng)。藥物指導(dǎo)及病因判斷的依據(jù)：我們報(bào)告了 mGGNs 術(shù)后治療的成功策略。對(duì)于無法有效切除的，則進(jìn)行了化療、放療、立體定向放療、免疫治療和靶向治療。 EGFR-TKI治療策略顯示出顯著優(yōu)勢(shì)，但如何達(dá)到更好的治療效果還需要更多研究。關(guān)鍵詞：表皮生長因子受體酪氨酸激酶抑制劑（EGFR-TKI）；多發(fā)磨玻璃結(jié)節(jié) (mGGNs)；同步多原發(fā)性肺癌 (SMPLC)。

腫瘤發(fā)生與革命國際數(shù)據(jù)庫描述：

Background: Multiple ground-glass nodules (mGGNs) in the lung has been defined as synchronous multiple primary lung cancer (SMPLC), it is has been very difficult challenging to differentiate SMPLC from intrapulmonary metastases, and its treatment remains controversial.Case presentation: We report a case simultaneously involving mGGNs and lung adenocarcinoma harboring primary EGFR-T790M mutation, in which the patient underwent the radical resection of lesions in the left upper lung, and continued the osimertinib treatment for the residual mGGNs in all lobes of the right lung. These mGGNs displayed different responses to osimertinib.Conclusions: We reported a successful strategy on the postoperative treatment for mGGNs. For those that cannot be completely resected, the chemotherapy, radiotherapy, stereotactic body radiation therapy, immunotherapy and targeted therapy have been performed instead. The EGFR-TKI therapy strategy showed significant advantages, but how to achieve even better therapeutic effect needs more researches.Keywords: Epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI); Multiple ground-glass nodules (mGGNs); Synchronous multiple primary lung cancer (SMPLC).