背景:面向原癌基因的靶向治疗在患有多原发肿瘤的老年患者中的益处有限。
方法:一名患有间变性淋巴瘤激酶阳性肺腺癌的女性患者在接受克唑替尼靶向治疗3年后出现获得性耐药。
方法:意外的后续原发性胆囊肿瘤的诊断。
方法:治疗性给予乐伐替尼。同时,通过与生物信息学方法比较肿瘤驱动突变基因,分析克唑替尼治疗前后的下一代测序结果.
结果:患者死于腹水和肝衰竭。此外,发现旁路激活是该患者获得耐药性的主要原因,抑癌基因和衰老相关基因的异常表达可能是第二原发肿瘤的原因。
结论:老年肿瘤患者治疗前和治疗后测序的生物信息学比较是令人感兴趣的。
结论:对于诊断,精确的生物信息学分析和重复活检同样有价值。为了治疗,潜在的治疗方法,如p53基因替代疗法和CAR-T疗法,需要对衰老相关疾病进行治疗.
BACKGROUND: Proto-oncogene-oriented targeted therapy has limited benefits in elderly patients with multiple primary tumors.
METHODS: A woman with anaplastic lymphoma kinase-positive lung adenocarcinoma developed acquired resistance after 3 years of targeted therapy with crizotinib.
METHODS: Diagnosis of unexpected subsequent primary gallbladder tumor.
METHODS: Lenvatinib was administered therapeutically. Meanwhile, next-generation sequencing results before and after crizotinib treatment were analyzed by comparing the tumor-driving mutation genes with bioinformatics methods.
RESULTS: The patient died of ascites and liver failure. Furthermore, bypass activation was found to be the main reason for acquired drug resistance for this patient, and the abnormal expression of tumor suppressor genes and senescence-related genes was the likely cause of the second primary tumor.
CONCLUSIONS: A bioinformatic comparison of pre- and post-treatment sequencing in elderly oncology patients is of interest.
CONCLUSIONS: For diagnosing, precision bioinformatics analysis and repeat biopsy are equally valuable. For therapy, potential therapy such as p53 gene replacement therapy and CAR-T therapy need to be practiced for senescence-related conditions.