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    • 4. 发明申请
    • GENOMIC ALTERATIONS IN THE TUMOR AND CIRCULATION OF PANCREATIC CANCER PATIENTS
    • 胰腺癌患者肿瘤和循环中的基因变异
    • WO2016134136A2
    • 2016-08-25
    • PCT/US2016/018450
    • 2016-02-18
    • THE JOHNS HOPKINS UNIVERSITY
    • VELCULESCU, VictorSAUSEN, MarkADLEFF, VilmosPHALLEN, Jillian
    • C12Q1/68
    • C12Q1/6827C12Q1/6816C12Q1/6886C12Q2600/106C12Q2600/112C12Q2600/118C12Q2600/156
    • Pancreatic adenocarcinoma has the worst overall mortality of any solid tumor, with only 7% of patients surviving after 5 years. To evaluate the clinical implications of genomic alterations in this low cellularity tumor type, we deeply sequenced the genomes of 101 enriched pancreatic adenocarcinomas from patients who underwent potentially curative resections and used non-invasive approaches to examine tumor specific mutations in the circulation of these patients. These analyses revealed somatic mutations in chromatin regulating genes including MLL and ARID1A in 20% of patients that were associated with improved survival. Liquid biopsy analyses of cell free plasma DNA revealed that 43% of patients with localized disease had detectable circulating tumor DNA (ctDNA) in their blood at the time of diagnosis. Detection of ctDNA after resection predicted clinical relapse and poor outcome, and disease recurrence by ctDNA was detected 6.5 months earlier than with standard CT imaging.
    • 胰腺癌具有任何实体瘤的总死亡率最差,5年后只有7%的患者存活。 为了评估基因组改变在这种低细胞性肿瘤类型中的临床意义,我们对经历了潜在治愈性切除术的患者进行了101个富集的胰腺腺癌的基因组测序,并使用非侵入性方法来检查这些患者的循环中的肿瘤特异性突变。 这些分析揭示了染色质调节基因中的体细胞突变,包括MLL和ARID1A在20%与改善生存相关的患者中。 无细胞血浆DNA的液体活检分析显示,43%的局部疾病患者在诊断时血液中可检测到循环肿瘤DNA(ctDNA)。 检测切除后的ctDNA预测临床复发和结果不良,ctDNA的疾病复发比标准CT成像早6.5个月。