将患者 mRNA 表达谱与抗癌药物疗效联系起来的变革性技术

Onco Pub Date : 2024-07-14 DOI:10.3390/onco4030012
Chen Yeh, Shu-Ti Lin, Hung-Chih Lai
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摘要

由于靶向治疗和免疫疗法等精准医疗往往存在可及性有限、反应率低和耐药性演变等问题,因此迫切需要开发简单、低成本、周转快的个性化诊断技术,以实现高灵敏度、快速和准确的药物反应预测。采用数字数据库建模的药物反应预测策略面临的主要挑战是标注临床数据稀缺、仅适用于少数几类药物,以及失去对患者个体水平的分辨率。虽然大规模癌症细胞系数据集和更多基于患者相关细胞的系统已部分解决了这些难题,但不同数据类型的整合以及从临床前到临床的数据转换仍很遥远。为了通过临床验证的药物反应预测分析克服精准医疗目前存在的局限性,我们开发了一种基于体外患者测试和硅学数据分析的创新专有技术。首先,通过对患者血液中的无细胞 mRNA(cfmRNA)进行转录组分析,建立了源自患者的基因表达特征。其次,进行了基因到药物的数据融合和数据传输的叠加机制。最后,采用半监督方法从约 700 种已批准、在研或临床试验候选药物中进行数据库搜索、匹配、注释和药效排序。可在一周内提供个性化的药物反应报告,为临床决策提供依据。与没有 PGA 支持的治疗方案相比,PGA(患者基因表达信息型抗癌药物疗效)测试显著改善了患者的治疗效果。PGA 将患者独有的 cfmRNA 指纹与药物图谱能力结合在一起,在患者对治疗不再有反应以及用尽标准疗法时,PGA 的实施有可能确定治疗方案。
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A Transformative Technology Linking Patient’s mRNA Expression Profile to Anticancer Drug Efficacy
As precision medicine such as targeted therapy and immunotherapy often have limited accessibility, low response rate, and evolved resistance, it is urgent to develop simple, low-cost, and quick-turnaround personalized diagnostic technologies for drug response prediction with high sensitivity, speed, and accuracy. The major challenges of drug response prediction strategies employing digital database modeling are the scarcity of labeled clinical data, applicability only to a few classes of drugs, and losing the resolution at the individual patient level. Although these challenges have been partially addressed by large-scale cancer cell line datasets and more patient-relevant cell-based systems, the integration of different data types and data translation from pre-clinical to clinical utilities are still far-fetched. To overcome the current limitations of precision medicine with a clinically proven drug response prediction assay, we have developed an innovative and proprietary technology based on in vitro patient testing and in silico data analytics. First, a patient-derived gene expression signature was established via the transcriptomic profiling of cell-free mRNA (cfmRNA) from the patient’s blood. Second, a gene-to-drug data fusion and overlaying mechanism to transfer data were performed. Finally, a semi-supervised method was used for the database searching, matching, annotation, and ranking of drug efficacies from a pool of ~700 approved, investigational, or clinical trial drug candidates. A personalized drug response report can be delivered to inform clinical decisions within a week. The PGA (patient-derived gene expression-informed anticancer drug efficacy) test has significantly improved patient outcomes when compared to the treatment plans without PGA support. The implementation of PGA, which combines patient-unique cfmRNA fingerprints with drug mapping power, has the potential to identify treatment options when patients are no longer responding to therapy and when standard-of-care is exhausted.
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