文献詳細
今月の臨床 ゲノム時代の婦人科がん診療を展望する─がんの個性に応じたpersonalizationへの道
【総論】
文献概要
●がんに起こる遺伝子変異には,がんの発生や進展に強くかかわるドライバー変異と,付随的な結果として生じるパッセンジャー変異があり,ドライバー変異を標的とした薬剤では高い奏効率が期待される.
●分子標的治療薬として,がん細胞自身に存在する分子だけではなく,がん環境の分子を標的とした創薬も進んでおり,その代表が血管新生阻害薬である.
●分子標的薬の使用においてはバイオマーカーの探求とvalidationを念頭におく必要がある.
●分子標的治療薬として,がん細胞自身に存在する分子だけではなく,がん環境の分子を標的とした創薬も進んでおり,その代表が血管新生阻害薬である.
●分子標的薬の使用においてはバイオマーカーの探求とvalidationを念頭におく必要がある.
参考文献
1) Druker BJ, et al : Five-year follow-up of patients receiving imatinib for chronic myeloid leukemia. N Engl J Med 355 : 2408─2417, 2006
2) Fukuoka M, et al : Multi-institutional randomized phase II trial of gefitinib for previously treated patients with advanced non-small-cell lung cancer(The IDEAL 1 Trial). J Clon Oncol 21 : 2237─2246, 2003
3) Kris MG, et al : Efficacy of gefitinib, an inhibitor of the epidermal growth factor receptor tyrosine kinase, in symptomatic patients with non-small cell lung cancer : a randomized trial. JAMA 290 : 2149─2158, 2003
4) Thatcher N, et al : Gefitinib plus best supportive care in previously treated patients with refractory advanced non-small-cell lung cancer : results from a randomised, placebo-controlled, multicentre study(Iressa Survival Evaluation in Lung Cancer). Lancet 366 : 1527─1537, 2005
5) Lynch TJ, et al : Activating mutations in the epidermal growth factor receptor underlying responsiveness of non-small-cell lung cancer to gefitinib. N Engl J Med 350 : 2129─2139, 2004
6) Paez JG, et al : EGFR mutations in lung cancer : correlation with clinical response to gefitinib therapy. Science 304 : 1497─1500, 2004
7) Soda M, et al : Identification of the transforming EML4-ALK fusion gene in non-small-cell lung cancer. Nature 448 : 561─566, 2007
8) Kwak EL, et al : Anaplastic lymphoma kinase inhibition in non-small-cell lung cancer. N Engl J Med 363 : 1693─1703, 2010
9) Choi YL, et al : EML4-ALK mutations in lung cancer that confer resistance to ALK inhibitors. N Engl J Med 363 : 1734─1739, 2010
10) Cancer Genome Atlas Research Network : Integrated genomic analyses of ovarian carcinoma. Nature 474 : 609─615, 2011
11) Tewari KS, et al : Improved survival with bevacizumab in advanced cervical cancer. N Engl J Med 370 : 734─743, 2014
12) Monk BJ, et al : Anti-angiopoietin therapy with trebananib for recurrent ovarian cancer(TRINOVA-1) : a randomised, multicentre, double-blind, placebo-controlled phase 3 trial. Lancet Oncol 15 : 799─808, 2014
13) Grisham RN, et al : BRAF mutation is associated with early stage disease and improved outcome in patients with low-grade serous ovarian cancer. Cancer 119 : 548─554, 2013
14) Farley J, et al : Selumetinib in women with recurrent low-grade serous carcinoma of the ovary or peritoneum : an open-label, single-arm, phase 2 study. Lancet Oncol 14 : 134─140, 2013
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