晚期卵巢癌患者福音!二代测序助力FDA加速批准卵巢癌新药

2016-12-23 生物探索 生物探索

导读 2016年12月19日,FDA加速批准了用于经过已经用两种或更多种化疗治疗并且携带有害的BRCA1和BRCA2基因突变的晚期卵巢癌患者的新药Rucaparib。而在指导用药方面,正是通过下一代测序(NGS)技术来检测患者是否携带BRCA1和BRCA2基因突变,如果患者具有BRCA1/2有害突变的阳性结果,则可能适合接受Rubraca治疗。部分卵巢癌患者伴有BRCA基因突变据美国癌症研究所统计

导读 2016年12月19日,FDA加速批准了用于经过已经用两种或更多种化疗治疗并且携带有害的BRCA1和BRCA2基因突变的晚期卵巢癌患者的新药Rucaparib。而在指导用药方面,正是通过下一代测序(NGS)技术来检测患者是否携带BRCA1和BRCA2基因突变,如果患者具有BRCA1/2有害突变的阳性结果,则可能适合接受Rubraca治疗。


部分卵巢癌患者伴有BRCA基因突变

据美国癌症研究所统计:2016年,约有22,280名妇女被诊断患有卵巢癌,14,240死于这个卵巢癌,其中约15%至20%的卵巢癌患者伴有一个BRCA基因突变。

2016年12月19日,美国食品和药物管理局(FDA)加速批准了Rucaparib(商品名Rubraca,Clovis Oncology公司生产)用于经过两线或两线以上化疗的和BRCA基因突变相关的晚期卵巢癌。此外,FDA还授予Rubraca突破性疗法、孤儿药认定和优先审评资格。

据悉,此次批准是基于两项临床研究的有效结果。首先参与者患有晚期卵巢癌,BRCA基因突变检测阳性,且经过两线或两线以上的化疗。

Rucaparib(商品名Rubraca)治疗的客观应答率为54%;在对铂类敏感的患者中,治疗的客观应答率为66%;在对铂类不敏感的患者中,治疗的客观应答率为25%;在对铂类顽固的患者中,治疗的客观应答率为0%;治疗的客观应答率在BRCA1和BRCA2基因突变的患者中没有差别。中位应答持续时间为9.2个月。

首个基于二代测序的伴随诊断试剂盒


值得一提的是,FDA同时批准了和Rubraca同时使用的基因检测,基于下一代测序(NGS)的检测方法——Foundation Medicine公司的FoundationFocus CDxBRCA产品,这是市场上首个基于二代测序的伴随诊断试剂盒。

FDA的药品评价和研究中心中血液学和肿瘤办公室主任和FDA的卓越肿瘤中心代理主任Richard Pazdur,M.D.说,Rubraca和 CDxBRCA的批准,见证了开发靶向患者基因中特异性突变引起的癌症治疗药物,这为一些因基因突变而试用了至少2种治疗方式的卵巢癌患者提供了另一个治疗选择。

Rubraca是一种聚ADP-核糖聚合酶(PARP)抑制剂,它可阻断涉及修复受损伤DNA的酶,从而使得癌细胞内有被损伤BRCA基因的DNA可能减少或被修复,让肿瘤细胞生长停止。

此外,Rubraca最常见的的不良反应有恶心、疲劳(包括虚弱)、呕吐、贫血、腹痛、味觉障碍、便秘、食欲下降、腹泻、血小板降低和气喘(发生率大于或等于20%);10%的患者由于不良反应而停药,主要为疲劳和虚弱;0.5%的患者发生了骨髓增生异常综合征/急性髓系白血病。患者在治疗前和治疗期间每个月应该检测血象,如发生骨髓增生异常综合征/急性髓系白血病应该停药。

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