【佳学基因靶向药物基因检测】前列腺癌的 DNA 损伤修复缺陷和靶向放射性核素治疗：突变真的很重要吗？系统回顾

如何知道我是否有经典基因评价

探索肿瘤的基因组学特征与治疗方案设计到了《Life (Basel)》在 2022 Dec 24;13(1):55.发表了一篇题目为《Review》肿瘤靶向药物治疗基因检测临床研究文章。该研究由Luca Filippi, Barbara Palumbo, Oreste Bagni, Viviana Frantellizzi, Giuseppe De Vincentis, Orazio Schillaci等完成。促进了肿瘤的精准治疗与个性化用药的发展，进一步强调了基因信息检测与分析的重要性。

肿瘤基因检测及靶向药物治疗研究关键词：

聚苯乙烯,精准肿瘤学,前列腺癌;放射性核素治疗,镭。

肿瘤治疗检测基因临床应用结果

本综述的目的是评估 DNA 损伤修复 (DDR) 突变对接受 [223Ra]RaCl2 放射性核素治疗（223Ra 疗法）的晚期前列腺癌 (PCa) 患者 (pts) 的反应和结果的影响或前列腺特异性膜抗原 (PSMA) 配体。使用两个主要数据库根据 PRISMA 标准进行系统的文献检索。仅选择了截至 2022 年 10 月以英语发表且纳入患者≥10 名的研究。选择了七项研究，包括 326 名患者，其中 201 名 (61.6%) 患有 DDR 缺陷。大多数选定的论文都是回顾性的，七分之四 (57.1%) 的样本量较小 (<50 pts)。七项研究中的三项 (42.8%) 报告了与没有 DDR 缺陷的受试者相比，在使用 α 发射体（223Ra 疗法或 [225Ac]Ac-PSMA-617）治疗后，有更有利的结果（总体或无进展生存期）突变。在两项使用 alpha 或 beta 发射器 ([177Lu]/[225Ac]-PMSA) 的研究中，没有显着的益处被记录在怀有 DDR 缺陷的患者中。在除一篇论文外的所有论文中，有或没有 DDR 突变的患者的反应率没有显着差异。尽管初步数据和回顾性设计存在偏差，但初步数据表明，接受 α 发射体放射性核素靶向治疗的携带 DDR 缺陷的 PCa 患者有更长的生存期。精准肿瘤学；前列腺癌;放射性核素治疗；镭。

肿瘤发生与革命国际数据库描述：

The aim of the present review was to assess the impact of DNA damage repair (DDR) mutations on response and outcome of patients (pts) affected by advanced prostate cancer (PCa) submitted to radionuclide therapies with [223Ra]RaCl2 (223Ra-therapy) or prostate specific membrane antigen (PSMA) ligands. A systematic literature search according to PRISMA criteria was made by using two main databases. Only studies published up until to October 2022 in the English language with ≥10 enrolled patients were selected. Seven studies including 326 pts, of whom 201 (61.6%) harboring DDR defects, were selected. The majority of selected papers were retrospective and four out of seven (57.1%) had small sample size (<50 pts). Three out of seven (42.8%) studies reported a more favorable outcome (overall or progression free survival) after therapy with alpha emitters (223Ra-therapy or [225Ac]Ac-PSMA-617) in subjects with DDR defects with respect to those without mutations. In two studies employing alpha or beta emitters ([177Lu]/[225Ac]-PMSA), no significant benefit was registered in pts harboring DDR defects. In all but one paper, no significant difference in response rate was reported among pts with or without DDR mutations. Although preliminary and biased by the retrospective design, preliminary data suggest a trend towards a longer survival in PCa pts harboring DDR defects submitted to radionuclide targeted therapy with alpha emitters.Keywords: PSMA; precision oncology; prostate cancer; radionuclide therapy; radium.