دورية أكاديمية
Liquid Versus Tissue Biopsy for Detecting Acquired Resistance and Tumor Heterogeneity in Gastrointestinal Cancers
| العنوان: | Liquid Versus Tissue Biopsy for Detecting Acquired Resistance and Tumor Heterogeneity in Gastrointestinal Cancers |
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| المؤلفون: | Leshchiner, Ignaty, Elagina, Liudmila, Goyal, Lipika, Siravegna, Giulia, Livitz, Dimitri, Hanna, Megan, Wong, Alicia, Fece de la Cruz, Ferran, Giantonio, Bruce, Roeland, Eric, Ryan, David P., Aguet, François, Hazar-Rethinam, Mehlika, Dias-Santagata, Dora, Bardelli, Alberto, Parida, Laxmi, Juric, Dejan, Getz, Gad, Corcoran, Ryan B., Parikh, Aparna, Levovitz, Chaya, Rhrissorrakrai, Kahn, Martin, Elizabeth, Van Seventer, Emily, Slowik, Kara, Ultro, Filippo, Pinto, Christopher, Danysh, Brian, Fetter, Isobel, Shahzade, Heather, Nadres, Brandon, Allen, Jill, Blaszkowsky, Lawrence, Clark, Jeffrey, Murphy, Janet, Nipp, Ryan, Weekes, Colin, Kwan, Eunice, Faris, Jason, Wo, Jennifer, Dey-Guha, Ipsita, Ting, David, Zhu, Andrew, Hong, Theodore, Golub, Todd, Iafrate, John, Adalsteinsson, Viktor |
| المصدر: | Nat Med |
| بيانات النشر: | Springer Science and Business Media LLC |
| سنة النشر: | 2019 |
| المجموعة: | Harvard University: DASH - Digital Access to Scholarship at Harvard |
| مصطلحات موضوعية: | General Biochemistry, Genetics and Molecular Biology, General Medicine |
| الوصف: | During cancer therapy, tumor heterogeneity can drive the evolution of multiple tumor subclones harboring unique resistance mechanisms in an individual patient1-3. Prior case reports and small case series have suggested that liquid biopsy (specifically, cell-free DNA (cfDNA)) may better capture the heterogeneity of acquired resistance4-8. However, the effectiveness of cfDNA versus standard single-lesion tumor biopsies has not been directly compared in larger scale prospective cohorts of patients following progression on targeted therapy. Here, in a prospective cohort of 42 patients with molecularly-defined gastrointestinal cancers and acquired resistance to targeted therapy, direct comparison of post-progression cfDNA versus tumor biopsy revealed that cfDNA more frequently identified clinically-relevant resistance alterations and multiple resistance mechanisms, detecting resistance alterations not found in the matched tumor biopsy in 78% of cases. Whole-exome sequencing of serial cfDNA, tumor biopsies, and rapid autopsy specimens elucidated substantial geographic and evolutionary differences across lesions. Our data suggest that acquired resistance is frequently characterized by profound tumor heterogeneity, and that the emergence of multiple resistance alterations in an individual patient may represent the “rule” rather than the “exception.” These findings have profound therapeutic implications and highlight the potential advantages of cfDNA over tissue biopsy in the setting of acquired resistance. ; Version of Record |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | application/pdf |
| اللغة: | English |
| تدمد: | 1078-8956 1546-170X |
| العلاقة: | Nature Medicine; Parikh, Aparna R., Leshchiner, Ignaty, Elagina, Liudmila, Goyal, Lipika, Levovitz, Chaya, Siravegna, Giulia, and Livitz, Dimitri, et. al. 2019. Liquid versus Tissue Biopsy for Detecting Acquired Resistance and Tumor Heterogeneity in Gastrointestinal Cancers. Nature Medicine 25, no. 9: 1415-1421.; https://nrs.harvard.edu/URN-3:HUL.INSTREPOS:37373054Test |
| DOI: | 10.1038/s41591-019-0561-9 |
| الإتاحة: | https://doi.org/10.1038/s41591-019-0561-9Test https://nrs.harvard.edu/URN-3:HUL.INSTREPOS:37373054Test |
| رقم الانضمام: | edsbas.80387608 |
| قاعدة البيانات: | BASE |
| تدمد: | 10788956 1546170X |
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| DOI: | 10.1038/s41591-019-0561-9 |