JNCI:哪些乳腺癌患者适合辅助二磷酸盐治疗?

2016-03-05 Mechront 译 MedSci原创

近期有研究表明,使用二磷酸盐治疗可降低乳腺癌骨转移风险,改善患者生存率,但仍欠缺一个满意的生物标志物,以便进行更好的治疗。

背景:近期有研究表明,使用二磷酸盐治疗可降低乳腺癌骨转移风险,改善患者生存率,但仍欠缺一个满意的生物标志物,以便进行更好的治疗。

方法:比较人乳腺癌MDA-MB-231细胞骨转移、肺转移和非转移变异的蛋白质组,对辅助唑来膦酸的大型随机试验(AZURE-ISRCTN79831382)的患者的肿瘤组织微阵列进行免疫组织化学染色,以进行临床验证。使用Cox比例风险回归和Kaplan-Meier评估生存能力,使用对数秩检验分析蛋白表达、临床变量和远处转移事件时间的联系。 

结果:发现2个新的候选标志物:巨噬细胞帽蛋白(CAPG)和含PDZ结构域的GIPC1蛋白(GIPC1)。对AZURE试验进行Cox比例风险回归分析显示,如果这两种标志物蛋白在原发肿瘤上均高度表达,那么对照组(未使用唑来膦酸)第一次乳腺癌转移更容易转移到骨头(HR = 4.5, 95% CI = 2.1 to 9.8, P < .001),更容易死亡(HR(总生存)= 1.8,
95% CI = 1.01 to 3.24, P = .045) 。两种蛋白均高度表达的患者,唑来膦酸可降低10倍首次转移至骨的风险(与对照组相比,P = .008)。

结论:原发乳腺肿瘤阻止CAPG和GIPC1的表达可预测疾病预后,以及唑来膦酸治疗的益处,此外或许还可以使病人辅助二磷酸盐治疗的选择变得简单。

原始出处:

Westbrook JA, Cairns DA,et al.CAPG and
GIPC1: Breast Cancer Biomarkers for Bone Metastasis Development and Treatment.J
Natl Cancer Inst.
2016 Jan 12;108(4). pii: djv360. doi: 10.1093/jnci/djv360.
Print 2016 Apr.

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