专题讲座肿瘤的个体化治疗.ppt

肿瘤个体化治疗基础讨论和临床实践的结合;医学模式的转变; ;肿瘤个体化治疗讨论整体方案;一、肿瘤易感性猜测与个体化治疗模式;肿瘤易感性猜测与个体化治疗讨论策略;Association between a 15q25 gene variant, smoking quantity and tobacco-related cancers among 17 000 individuals. Int J Epidemiol. 2009 Sep 23. Genome-wide association and replication studies identify four variants associated with prostate cancer susceptibility. Nat Genet. 2009 Sep 20. A genome-wide association study identifies a new ovarian cancer susceptibility locus on 9p22.2. Nat Genet. 2009 Sep;41(9):996-1000. Genome-wide association study identifies variants in the ABO locus associated with susceptibility to pancreatic cancer. Nat Genet. 2009 Sep;41(9):986-90. ;二、肿瘤预后猜测与个体化治疗讨论 ---筛选肿瘤侵袭性相对高、预后不良的患者而进一步治疗;乳腺癌;A Genomic Strategy to Refine Prognosisin Early-Stage Non–Small-Cell Lung Cancer. N Engl J Med. 2006 Aug 10;355(6):570-80 A five-gene signature and clinical outcome in non-small-cell lung cancer.N Engl J Med,2007,356(1):11-20 Three immunomarker support vector machines-based prognostic classifiers for stage IB non-small-cell lung cancer. J Clin Oncol. 2009;27(7):1091-9. Identification of gene signatures and molecular markers for human lung cancer prognosis using an in vitro lung carcinogenesis system. Cancer Prev Res (Phila Pa). 2009 Aug;2(8):702-11. ;Ongoing project ;局部晚期NSCLC患者经过综合治疗后，局部掌握率可达到50%以上，中位生存期为15-25个月。 局部晚期NSCLC脑转移的发生率高达21%-54%，39%的局部进展期NSCLC全脑转移发生在开头治疗的6个月后。 一旦消灭脑转移，其治疗手段便十分有限，预后很差，中位生存期3-6个月左右。;预防性全脑照耀（PCI）筑就肺癌脑转移的防线;肿瘤干细胞干性维持基因 表皮-间质转化相关基因 脑组织特异表达基因 细胞因子 ;三、药物疗效猜测与个体化治疗讨论 ---筛选获益患者，提高疗效，削减毒副反应;1.以细胞实验为基础的讨论;Ongoing project 耐吉非替尼肺癌人细胞株的建立及获得性耐药机制的探讨;Cell death rate after 24 h of gefitinib treatmentin PC-9-ZD cells and parental PC-9 cells;突变富集-液向芯片检测PC-9 和 PC-9-ZD 细胞中 EGFR、 K-RAS 、PIK3CA基因的突变;These four patients all showed EGFR mutant (E19 or E21, but no response to TKI, then we tested pathway of the same sample ;Ji Yuan, Ma Sheng-lin, et al.Anticancer Drugs. 2009 ;20(9): 832-837.;P21蛋白在临床标本中的表达;吉非替尼获得性耐药机制;Ongoing project吉非替尼耐