PDF(Pubmed)
Abstract：
BACKGROUND: Adolescents and young adults (AYAs) represent a small proportion of patients with cancer. The genomic profiles of AYA patients with cancer are not well-studied, and outcomes of genome-matched therapies remain largely unknown.
METHODS: We investigated differences between Japanese AYA and older adult (OA) patients in genomic alterations, therapeutic evidence levels, and genome-matched therapy usage by cancer type. We also assessed treatment outcomes.
RESULTS: AYA patients accounted for 8.3% of 876 cases. Microsatellite instability-high and/or tumor mutation burden was less common in AYA patients (1.4% versus 7.7% in OA; P = 0.05). However, BRCA1 alterations were more common in AYA patients with breast cancer (27.3% versus 1.7% in OA; P = 0.01), as were MYC alterations in AYA patients with colorectal cancer (23.5% versus 5.8% in OA; P = 0.02) and sarcoma (31.3% versus 3.4% in OA; P = 0.01). Genome-matched therapy use was similar between groups, with overall survival tending to improve in both. However, in AYA patients, the small number of patients prevented statistical significance. Comprehensive genomic profiling-guided genome-matched therapy yielded encouraging results, with progression-free survival of 9.0 months in AYA versus 3.7 months in OA patients (P = 0.59).
CONCLUSIONS: Our study suggests that tailored therapeutic approaches can benefit cancer patients regardless of age.
METHODS: We investigated differences between Japanese AYA and older adult (OA) patients in genomic alterations, therapeutic evidence levels, and genome-matched therapy usage by cancer type. We also assessed treatment outcomes.
RESULTS: AYA patients accounted for 8.3% of 876 cases. Microsatellite instability-high and/or tumor mutation burden was less common in AYA patients (1.4% versus 7.7% in OA; P = 0.05). However, BRCA1 alterations were more common in AYA patients with breast cancer (27.3% versus 1.7% in OA; P = 0.01), as were MYC alterations in AYA patients with colorectal cancer (23.5% versus 5.8% in OA; P = 0.02) and sarcoma (31.3% versus 3.4% in OA; P = 0.01). Genome-matched therapy use was similar between groups, with overall survival tending to improve in both. However, in AYA patients, the small number of patients prevented statistical significance. Comprehensive genomic profiling-guided genome-matched therapy yielded encouraging results, with progression-free survival of 9.0 months in AYA versus 3.7 months in OA patients (P = 0.59).
CONCLUSIONS: Our study suggests that tailored therapeutic approaches can benefit cancer patients regardless of age.
摘要：
背景：青少年和年轻人（AYAs）占癌症患者的一小部分。AYA癌症患者的基因组图谱没有得到很好的研究，基因组匹配疗法的结果在很大程度上仍然未知。
方法：我们调查了日本AYA和老年（OA）患者在基因组改变方面的差异，治疗证据水平，和癌症类型的基因组匹配治疗使用。我们还评估了治疗结果。
结果：AYA患者占876例的8.3%。微卫星不稳定性高和/或肿瘤突变负荷在AYA患者中不常见(1.4%对OA的7.7%;P=0.05)。然而,BRCA1改变在AYA乳腺癌患者中更为常见（在OA中为27.3%对1.7%；P=0.01），AYA结直肠癌患者的MYC改变(OA中23.5%对5.8%;P=0.02)和肉瘤(OA中31.3%对3.4%;P=0.01)。基因组匹配的治疗方法在组间相似，两者的总体生存率都有改善的趋势。然而,在AYA患者中，少数患者阻止了统计学意义。全面的基因组分析指导的基因组匹配疗法产生了令人鼓舞的结果，AYA患者的无进展生存期为9.0个月，OA患者为3.7个月（P=0.59）。
结论：我们的研究表明，无论年龄大小，量身定制的治疗方法都可以使癌症患者受益。
方法：我们调查了日本AYA和老年（OA）患者在基因组改变方面的差异，治疗证据水平，和癌症类型的基因组匹配治疗使用。我们还评估了治疗结果。
结果：AYA患者占876例的8.3%。微卫星不稳定性高和/或肿瘤突变负荷在AYA患者中不常见(1.4%对OA的7.7%;P=0.05)。然而,BRCA1改变在AYA乳腺癌患者中更为常见（在OA中为27.3%对1.7%；P=0.01），AYA结直肠癌患者的MYC改变(OA中23.5%对5.8%;P=0.02)和肉瘤(OA中31.3%对3.4%;P=0.01)。基因组匹配的治疗方法在组间相似，两者的总体生存率都有改善的趋势。然而,在AYA患者中，少数患者阻止了统计学意义。全面的基因组分析指导的基因组匹配疗法产生了令人鼓舞的结果，AYA患者的无进展生存期为9.0个月，OA患者为3.7个月（P=0.59）。
结论：我们的研究表明，无论年龄大小，量身定制的治疗方法都可以使癌症患者受益。
