a7.ngs用于指導(dǎo)晚期惡性腫瘤治療的

NGS用于指導(dǎo)晚 治InsightonNovelMechanismsandPrecision浙江大學(xué)醫(yī)學(xué)院附 醫(yī)院腫瘤內(nèi)PresentedByClaudineIsaacsat2016ASCOAnnual—甚至PresentedByDavidHayesat2016ASCOAnnual

02009201020112012201320142015NGS指導(dǎo)下的腫瘤免疫治 NGS在多種實(shí)體腫瘤治療中的應(yīng)—單核苷酸變異（突變—單核苷酸變異（突變—?????????（DNA或RNA特PresentedByDavidHayesat2016ASCOAnnual PresentedByDouglasJohnsonat2016ASCOAnnualPresentedByDouglasJohnsonat2016ASCOAnnual 抗PD-1/PD-L1的候選標(biāo)記 PresentedByDouglasJohnsonat2016ASCOAnnual PresentedByDouglasJohnsonat2016ASCOAnnualPresentedByDouglasJohnsonat2016ASCOAnnual PresentedByDouglasJohnsonat2016ASCOAnnual PresentedByDouglasJohnsonat2016ASCOAnnual PresentedByDouglasJohnsonat2016ASCOAnnual PresentedByDouglasJohnsonat2016ASCOAnnual PresentedByDouglasJohnsonat2016ASCOAnnual PresentedByDouglasJohnsonat2016ASCOAnnual PresentedByDouglasJohnsonat2016ASCOAnnual PresentedByDouglasJohnsonat2016ASCOAnnualTCR克 PresentedByDouglasJohnsonat2016ASCOAnnual PresentedByDouglasJohnsonat2016ASCOAnnual236-315 PresentedByDouglasJohnsonat2016ASCOAnnual PresentedByDavidHayesat2016ASCOAnnual在治療中，9個(gè)（39%）患者出現(xiàn)了13種突 PresentedByDavidHayesat2016ASCOAnnual縱縱向血漿游離DNA（n=23）的NGS發(fā)現(xiàn)克隆演者中為一致，3（13%）患者中為不一PresentedByLillianSmythat2016ASCOAnnual血漿游離DNA（cfDNA)的NGS揭示AKT1E17K突（AZD5363）I期籃子研究的患者分 其中一個(gè)驅(qū) ，AKT1E17K突—反復(fù)的（~2%），人 細(xì)胞對AKT1E17KPresentedByLillianSmythat2016ASCOAnnual 而單個(gè)病灶的活檢存在很多（異質(zhì)性，局限的可行PresentedByLillianSmythat2016ASCOAnnual背背 液體活 PresentedByLillianSmythat2016ASCOAnnual 發(fā)現(xiàn)及追蹤AKT1E17K描述具有AKT1E17KPresentedByLillianSmythat2016ASCOAnnual—AKT1E17K -已知具有RAS/RAF突變的腫瘤患者被排-根據(jù)RECISTv1.1標(biāo)準(zhǔn)定義，具有可測量病PresentedByLillianSmythat2016ASCOAnnual PresentedByLillianSmythat2016ASCOAnnual PresentedByLillianSmythat2016ASCOAnnual PresentedByLillianSmythat2016ASCOAnnualddPCR檢測到在D21，AKT1

AKT1追蹤腫瘤反分?jǐn)?shù)（MAF）在ddPCRPresentedByLillianSmythat2016ASCOAnnual治治療前cfDNA（n=25）的NGS發(fā)現(xiàn)腫瘤異質(zhì)在8個(gè)中檢測到17種額外的改變（共21發(fā)現(xiàn)3個(gè) 中同時(shí)出現(xiàn)了相關(guān)的突變KRAS），但是所有都對藥物治療沒有反PresentedByLillianSmythat2016ASCOAnnual PresentedByLillianSmythat2016ASCOAnnual治療前的cfDNA發(fā)現(xiàn)腫瘤異質(zhì) PresentedByLillianSmythat2016ASCOAnnual在這項(xiàng)探索性研究中，對通 panel捕獲的cfDNA迚行二是可行的，幵且不ddPCR得到的結(jié)果高度一 PresentedByLillianSmythat2016ASCOAnnual 變