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首页> 美国卫生研究院文献>OncoTargets and therapy >Genetic Analysis and Targeted Therapy Using Buparlisib and MK2206 in a Patient with Triple Metachronous Cancers of the Kidney Prostate and Squamous Cell Carcinoma of the Lung: A Case Report
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Genetic Analysis and Targeted Therapy Using Buparlisib and MK2206 in a Patient with Triple Metachronous Cancers of the Kidney Prostate and Squamous Cell Carcinoma of the Lung: A Case Report

机译：使用Buparlisib和MK2206在肺癌前列腺和鳞状细胞癌的患者中使用Buptlisib和MK2206的遗传分析和靶向治疗：案例报告

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Multiple primary cancers (MPC) occurring in the same individual is considered rare but being increasingly recognized owing to the longer cancer survival nowadays. Despite of accumulating experience in diagnosis, effective treatment remains to be problematic in many scenarios. Genetic testing-based targeted therapy could be an invaluable option for both diagnosis and treatment of such patients. Here we present a 74-year-old male with triple primary cancers including kidney, prostate, and lung with metastatic tumor on the costal bones. The patient visited the hospital for persistent cough and hemoptysis, and a diagnosis of squamous cell carcinoma of the left lung was made by bioptic fiberoptic bronchoscopy. A previous history included renal cancer controlled by Sorafenib and prostate cancer controlled by Goserelin. Radiotherapy and platinum-based chemotherapy failed to help the patient and the tumor size increased over a period of 6 months. In order to seek better therapeutical options, we performed targeted sequencing using the cancerous tissues from his lung, kidney, and prostate cancers. Briefly, the results identified VHL, EGFR, PIK3CA, TP53, and AKT1 mutations in lung cancer, AKT1, FGFR2, and TP53 mutations in renal cancer, and FGFR2 mutations in prostate cancer. A combined medication targeting PIK3CA and AKT1 signaling was recommended and the patient was given BKM120 (PIK3CA, Phase III clinical trial) and MK2206 (AKT, phase III clinical trial). Revisit chest CTs after 4 months and 9 months showed a significant shrinkage of tumor size by 40% and 80%, respectively. Our experience demonstrated a good example that genetic analysis could be valuable to diagnose and precisely treat multiple primary cancers.
机译：在同一个体中发生的多种主要癌症（MPC）被认为是罕见的，但由于现在癌症生存越来越越来越识别。尽管在诊断方面积累了经验，但在许多情况下有效治疗仍有问题。基于遗传测试的靶向治疗可能是对这些患者的诊断和治疗的无价选择。在这里，我们展示了一只74岁的男性，其中三重原发性癌症包括肾脏，前列腺和肺的肺部骨骼转移肿瘤。患者访问了持续咳嗽和咯血的医院，并通过生物光纤支气管镜检查进行左肺鳞状细胞癌的诊断。以前的历史包括由索拉昔林和由Goserelin控制的前列腺癌控制的肾癌。放射疗法和基于铂的化疗未能帮助患者，肿瘤大小在6个月内增加。为了寻求更好的治疗方案，我们使用肺癌，肾脏和前列腺癌的癌组织进行了针对性测序。简而言之，结果鉴定了肾癌，Akt1，FGFR2和TP53突变中的VHL，EGFR，PIK3CA，TP53和AKT1突变，以及前列腺癌中的FGFR2突变。建议使用靶向PIK3CA和AKT1信号的组合药物，并给予患者BKM120（PIK3CA，III期临床试验）和MK2206（AKT，III期临床试验）。 4个月后重新筛选胸部CTS分别显示出肿瘤大小的显着收缩40％和80％。我们的经验表明了一个很好的例子，即遗传分析可能是有价值的，以诊断和精确治疗多发性癌症。

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