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肺診斷-固態腫瘤DNA/RNA檢測

《非小細胞肺癌NCCN指南》明確指出,驅動基因突變狀態是靶向藥物治療的重要療效預測因素, 人類EGFR、HER2、KRAS、BRAF基因突變,ALK、ROS1、RET、NTRK1、NTRK2、NTRK3基因融合和MET外顯子14跳躍突變患者可以從相應酪氨酸激酶抑制劑治療中獲益,在進行標靶治療前需要對基因的突變狀態進行檢測,並強烈建議進行更廣泛的有效基因的狀態檢測,因此對NSCLC患者的多基因突變聯合檢測可為患者提供更精準的治療。

 

NCCN 指引建議標靶用藥

ALK Rearrangement

  • First-line therapy
    • Alectinib
    • Brigatinib
    • Ceritinib
    • Crizotinib
    • Lorlatinib
  • Subsequent therapy
    • Alectinib
    • Brigatinib
    • Ceritinib
    • Lorlatinib

BRAF V600E Mutation

  • First-line therapy
    • Dabrafenib/trametinib
    • Dabrafenib
    • Vemurafenib
  • Subsequent therapy
    • Dabrafenib / trametinib

EGFR Exon 19 Deletion or L858R

  • First-line therapy
    • Afatinib
    • Erlotinib
    • Dacomitinib
    • Gefitinib
    • Osimertinib
    • Erlotinib + ramucirumab
    • Erlotinib + bevacizumab
    • (nonsquamous)
  • Subsequent therapy
    • Osimertinib

EGFR S768I, L861Q, and/or G719X

  • First-line therapy
    • Afatinib
    • Erlotinib
    • Dacomitinib
    • Gefitinib
    • Osimertinib
  • Subsequent therapy
    • Osimertinib

EGFR Exon 20 Insertion Mutation

  • Subsequent therapy
    • Amivantamab-vmjw
    • Mobocertinib

ERBB2 (HER2) Mutation

  • Subsequent therapy
    • Fam-trastuzumab
    • deruxtecan-nxki
    • Ado-trastuzumab emtansine

KRAS G12C Mutation

  • Subsequent therapy
    • Sotorasib

MET Exon 14 Skipping Mutation

  • First-line / Subsequent therapy
    • Capmatinib
    • Crizotinib
    • Tepotinib

NTRK1/2/3 Gene Fusion

  • First-line/Subsequent therapy
    • Larotrectinib
    • Entrectinib

RET Rearrangement

  • First-line/Subsequent therapy
    • Selpercatinib
    • Pralsetinib
    • Cabozantinib

ROS1 Rearrangement

  • First-line therapy
    • Ceritinib
    • Crizotinib
    • Entrectinib
  • Subsequent therapy
    • Lorlatinib
    • Entrectinib

 

Gene List

含括上述所有NCCN指引建議標靶用藥所對應的基因變異

DNA RNA
  • BRAF
  • EGFR
  • HER2
  • KRAS
  • ALK
  • MET
  • NTRK1
  • NTRK2
  • NTRK3
  • RET
  • ROS1

註:DNA檢測SNV/InDel

註:RNA檢測Fusion/Skipping

檢測對象:

肺癌癌症患者

初次診斷為晚期癌症患者

使用標準治療成效不佳者

檢體種類:

腫瘤組織切片檢體

 

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