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Studi mendefinisikan kriteria untuk kanker paru-paru MET - diupayakan cocok untuk perawatan Crizotinib
Date:
September 8, 2015
Source:
University of Colorado Anschutz Medical Campus
Summary:
Banyak kanker meliputi peningkatan salinan gen MET . Tapi di mana kasus adalah MET mengemudikan kanker dan di mana meningkatkan salinan " ride alomg " dengan kelainan molekul lain yang merupakan penyebab sebenarnya dari penyakit ini ? Sebuah studi mendefinisikan kriteria untuk MET - memperkuat kanker yang cenderung sensitif terhadap pengobatan dengan Crizotinib .
.............. " Secara umum, ada dua cara yang jumlah salinan gen MET dapat ditingkatkan : Tumor dapat membuat beberapa salinan dari seluruh kromosom - kromosom 7 - . atau dapat memperkuat hanya wilayah MET dalam kasus pertama , MET tidak mungkin menjadi driver khusus biologi kanker , ....more.
Study defines
criteria for MET-driven lung cancer suitable for crizotinib treatment
Date:
September 8, 2015
Source:
University of Colorado Anschutz Medical Campus
Summary:
Many cancers include increased copies of the gene MET. But in which cases
is MET driving the cancer and in which do these increased copies happen to
"ride along" with other molecular abnormalities that are the true
cause of the disease? A study defines criteria for MET-amplified cancer likely
sensitive to treatment with crizotinib.
.................
Many cancers include increased copies of the gene MET. But in which cases
is MET driving the cancer and in which do these increased copies happen to
"ride along" with other molecular abnormalities that are the true
cause of the disease? The answer influences whether a tumor will respond to
drugs that inhibit MET, like crizotinib. A University of Colorado Cancer Center
study being presented today at the 16th World Conference on Lung Cancer in
Denver, Colorado sheds light on the best method to determine the threshold at
which MET amplification becomes clinically relevant.
"Generally, there are two ways that the number of copies of the MET
gene can be increased: The tumor can make multiple copies of the entire
chromosome on which it sits -- chromosome 7 -- or it can amplify just the MET
region. In the first case, MET is unlikely to be the specific driver of the
cancer's biology, it may just be a ride along. But if the MET region is
amplified separate from the rest of the chromosome, this would suggest that the
MET gene is indeed the area of specific importance to the cancer," says
Sinead Noonan, MD, investigator at the CU Cancer Center, senior thoracic
oncology fellow at the CU School of Medicine, and the study's first author.
The goal of the current study was to find evidence supporting the above
hypothesis and to identify a group of MET-driven patients in which crizotinib
would be effective.
To do so, Noonan worked with Marileila Garcia, PhD, CU Cancer Center
investigator and professor of Oncology at the CU School of Medicine, who
assessed the genetics of over 1,000 lung cancer patients. Using the low level
criteria commonly used for defining an increase in MET copy number, independent
of whether it was increased by increasing the overall number of copies of the
chromosome or just that region of the chromosome, 14.4 percent of these samples
were positive for MET copy number gain. The group then looked at another
measure, comparing MET copy number to the number of chromosome 7 centromeres --
the center point of the chromosome -- which allowed them to see how
specifically MET was amplified in comparison with the chromosome as a whole.
When the low level criteria for defining an increase in MET copy number using
the ratio of MET to centromere 7 was used, only 4.5 percent of these cases were
positive.
Now the question was what ratio of MET to centromere 7, exactly, defined
patients whose tumors were driven by this gene amplification and so would be
most susceptible to MET inhibition via crizotinib.
"There is almost always only one driver abnormality in any given
tumor," Noonan says. But in 47 percent of the tumors defined by the
minimal MET-to-centromere-7 ratio criteria, the group was able to identify
other known genetic drivers, including mutations or gene rearrangements in
EGFR, KRAS, BRAF, ALK, ERBB2, RET or ROS1.
"Strikingly, as we looked at cases with higher and higher MET
positivity, the degree of overlap with other known drivers decreased,"
Noonan says. In other words, as the MET-to-centromere-7 ratio increased, the
group was less likely to find any other candidates for the cause of the cancer.
A group completely free from overlap with other known cancer drivers was
only found in the group in which MET overbalanced centromere 7 by 5 times.
Using the other common method of simply counting MET, independent of the ratio,
it was impossible to find a group without additional known genetic driver.
"I think these data really help to solidify MET-to-centromere ratio as
the better measure for defining a lung cancer driven by MET copy number,"
says D. Ross Camidge, MD, PhD, Joyce Zeff Chair in Lung Cancer Research at the
CU Cancer Center and the senior author of the study. "While the highest
ratio only occurs in 0.34 percent of cases, it has clearly been associated with
responses to crizotinib approaching 70 percent. However, responses have also
been seen at lower ratios. Overall, if we look across all levels of MET-ratio
positive cases but exclude those with other identifiable drivers we can
identify a group representing 2.4 percent of adenocarcinomas which is ripe for
further investigation as potential MET-sensitive subtypes of lung cancer."
The drug company Pfizer has an ongoing clinical trial program to evaluate
the usefulness of crizotinib against a range of drivers, including MET copy
number-driven lung cancer. The drug has already been shown to be useful against
lung cancer driven by ALK and ROS1 gene rearrangements.
"There's definitely a population of patients with cancers sensitive to
MET inhibition that can be identified by MET copy number increase. The
challenge is finding these people accurately so they can get the best, most
personalized approach to treatment possible," says Noonan.
Story Source:
The above post is reprinted from materials provided byUniversity
of Colorado Anschutz Medical Campus. Note: Materials may be edited
for content and length.