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Molecular profiling of a case of advanced pancreatic cancer identifies an active and tolerable combination of targeted therapy with backbone chemotherapy

机译:一例晚期胰腺癌的分子谱分析确定了靶向治疗与骨干化疗的有效结合

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摘要

Typical survival with common 1st-line regimens for pancreatic cancer range from 6-11 months. We report a case of a patient with stage IVB pancreatic adenocarcinoma treated with gemcitabine and erlotinib who stopped therapy after 3 months without achieving a response due to intolerance. To decide upon additional treatment options, molecular analysis was performed on liver metastasis which revealed KRAS, FBXW7, APC, and ATM mutations, with thymidylate synthase (TS) negativity and PD-1 positivity. Based on this profile of TS negativity and ATM mutation, a combination strategy was devised consisting of capecitabine, oxaliplatin, bevacizumab and vorinostat. The patient had a near complete response to therapy with this regimen. In refractory metastatic pancreatic cancer, responses of this magnitude are rarely seen. To our knowledge, this represents the first demonstrated activity of this combination in the metastatic setting which could prompt further investigation of its use in large scale clinical trials.
机译:胰腺癌的常用1st-sup-line方案的典型生存期为6-11个月。我们报告了吉西他滨和厄洛替尼治疗的IVB期胰腺腺癌患者的病例,该患者在3个月后因不耐受而没有反应而停止治疗。为了决定其他治疗方案,对肝转移进行了分子分析,结果显示KRAS,FBXW7,APC和ATM突变,胸苷酸合酶(TS)阴性,PD-1阳性。基于TS阴性和ATM突变的这种情况,设计了一种联合策略,包括卡培他滨,奥沙利铂,贝伐单抗和伏立诺他。该方案对患者的治疗几乎完全有效。在难治性转移性胰腺癌中,这种反应很少见。据我们所知,这代表了该组合在转移环境中的首次展示活性,这可能会促使进一步研究其在大规模临床试验中的用途。

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