학술논문
Utility of Comprehensive Genomic Profiling Tests for Patients with Incurable Pancreatic Cancer in Clinical Practice
Document Type
article
Author
Takuo Yamai; Kenji Ikezawa; Naotoshi Sugimoto; Makiko Urabe; Yugo Kai; Ryoji Takada; Tasuku Nakabori; Hiroyuki Uehara; Takahisa Kawamura; Kei Kunimasa; Sachiko Yamamoto; Toru Wakamatsu; Takuji Hayashi; Yoji Kukita; Fumie Fujisawa; Tazuko Inoue; Yuko Yamaguchi; Tomoyuki Yamasaki; Keiichiro Honma; Kazuyoshi Ohkawa
Source
Cancers, Vol 15, Iss 3, p 970 (2023)
Subject
Language
English
ISSN
15030970
2072-6694
2072-6694
Abstract
Although comprehensive genomic profiling (CGP) tests have been covered under the Japanese national health insurance program since 2018, the utility and issues of CGP tests have not been clarified. We retrospectively reviewed 115 patients with incurable pancreatic cancer (IPC) who underwent CGP tests in a Japanese cancer referral center from November 2019 to August 2021. We evaluated the results of CGP tests, treatments based on CGP tests, and survival time. Eight cases (6.9%) were diagnosed as tumor mutation burden-high (TMB-H) and/or microsatellite instability-high (MSI-H). The gene mutation rates of KRAS/TP53/CDKN2A/SMAD4 were 93.0/83.0/53.0/25.2%, respectively. Twenty-five patients (21.7%) had homologous recombination deficiency (HRD)-related genetic mutations. Four patients (3.5%) having TMB-H and/or MSI-H were treated with pembrolizumab, and only two patients (1.7%) participated in the clinical trials. Patient characteristics were not significantly different between patients with and without HRD-related gene mutations. The median OS was significantly longer in the HRD (+) group than in the HRD (−) group (749 days vs. 519 days, p = 0.047). In multivariate analysis, HRD-related gene mutation was an independent prognostic factor associated with favorable OS. CGP tests for patients with IPC have the potential utility of detecting HRD-related gene mutations as prognostic factors as well as a therapeutic search.