探索癌症

大腸癌病人如果癌症起因於基因修復(MMR)缺陷
使用Keytruda 反應率(ORR)高達62% 疾病控制率(DCR)高達92%
但若是沒有此缺陷 反應率是0% 疾病控制率(DCR)為16%

48位臨床實驗大腸癌病人 每位都接受過多次化放療 其中13位有基因修復缺陷
在用Keytruda 治療後 8位腫瘤縮小 反應率為62% 其他25位沒有基因修復缺陷的病人 沒有一位有反應 反應率為0%

in 48 evaluable, heavily pre-treated patients with advanced colorectal cancer and other solid tumors. In the colorectal cancer group with MMR-deficient tumors, an objective response rate (ORR) of 62 percent was observed (n=8/13). In contrast, no responses were observed in the colorectal cancer group with MMR-proficient tumors (n=0/25).

醫學的Overall Response Rate (ORR) 我翻譯為反應率 是有嚴謹定義的
ORR是指腫瘤有縮小的比率 還有一群人有免疫反應 但是因為種種原因
(像是基因突變數量 見下文) 免疫反應不足以讓腫瘤縮小 但是病人病情穩定
病情沒有繼續惡化 醫學用 disease control rate (DCR) 來區別

Keytruda 在有基因修補缺陷的大腸癌病人ORR是62% DCR 是92%
Keytruda 在沒有基因修補缺陷的大腸癌病人ORR是0% DCR 是16%

In the group with MMR-deficient colorectal cancer, the ORR was 62 percent and the disease control rate (DCR) was 92 percent. No responses were observed in the colorectal cancer group with MMR-proficient tumors and the DCR was 16 percent.

ORR 62% DCR 92%是讓人驚喜的數字
相信是有基因修復(MMR)缺陷的病友的福音
如果你的醫師太忙還沒注意到這消息
底下這網頁是ASCO的官網

ASCO 2015: Mismatch Repair Deficiency Predicts Response to Pembrolizumab Among Patients With Colorectal and Other Cancers

http://www.ascopost.com/ViewNews.aspx?nid=27670

我不是在談未來
anti pd1藥已經有了 MMR缺陷測試是很普遍的測試
大腸癌病友應該都要測驗一下有沒有MMR缺陷

MMR 缺陷的病人 平均有1782個突變
沒有MMR 缺陷的病人平均有73個突變
越多突變免疫系統越容易辨識癌細胞 免疫反應也越大
Keytruda 效果也越明顯

In this study, mismatch repair–deficient tumors had an average of 1,782 mutations, compared to 73 mutations in mismatch repair–proficient tumors. Higher numbers of mutations were linked to better response to pembrolizumab.