With the significant advances in cancer genomics using next-generation sequencing technologies,genomic and molecular profilingbased precision medicine is used as a part of routine clinical test for guiding and selecti...With the significant advances in cancer genomics using next-generation sequencing technologies,genomic and molecular profilingbased precision medicine is used as a part of routine clinical test for guiding and selecting the most appropriate treatments for individual cancer patients.Although many molecular-targeted therapies for a number of actionable genomic alterations have been developed,the clinical application of such information is still limited to a small proportion of cancer patients.In this review,we summarize the current status of personalized drug selection based on genomic and molecular profiling and highlight the challenges how we can further utilize the individual genomic information.Cancer immunotherapies,including immune checkpoint inhibitors,would be one of the potential approaches to apply the results of genomic sequencing most effectively.Highly cancer-specific antigens derived from somatic mutations,the so-called neoantigens,occurring in individual cancers have been in focus recently.Cancer immunotherapies,which target neoantigens,could lead to a precise treatment for cancer patients,despite the challenge in accurately predicting neoantigens that can induce cytotoxic T cells in individual patients.Precise prediction of neoantigens should accelerate the development of personalized immunotherapy including cancer vaccines and T-cell receptor-engineered T-cell therapy for a broader range of cancer patients.展开更多
Recent genome-wide association studies have identified lung cancer susceptibility loci, such as chromosome 5p15 (telomerase reverse transcriptase, TERT and cleft lip and palate transmembrane protein 1-like, CLPTM1L), ...Recent genome-wide association studies have identified lung cancer susceptibility loci, such as chromosome 5p15 (telomerase reverse transcriptase, TERT and cleft lip and palate transmembrane protein 1-like, CLPTM1L), 15q25 (nicotinic cholinergic receptor α, CHRNA3-CHRNA5), and 3q28 (tumor protein p63, TP63). Replication study was performed to confirm the association of the recently-identified susceptible loci (i.e., TERT-CLPTM1L, CHRNA3-CHRNA5, and TP63) in a total of 1460 male Japanese smokers (885 lung cancer cases and 575 healthy control subjects), which were previously studied for a low odds ratio of impaired or deletion polymorphism in cytochrome P450 2A6 (CYP2A6) for lung cancer risk. The minor allele frequency (0.442) of rs2736100 on 5p15 (TERT) was significantly higher in lung cancer cases than that (0.395) of controls, with an odds ratio of 1.27 (95% CI of 1.07 - 1.50, p = 0.00504). A series of subgroup analyses revealed the significant associations of rs4488809 (TP63, odds ratio of 1.21, p = 0.0422) and rs2736100 (TERT, odds ratio of 1.47, p = 6.40 × 10–5) with the risk of lung adenocarcinoma. No significant association of CHRNA3-CHRNA5 and CLPTM1L was found in this population. The present results support replication of the association of TERT and TP63 loci with lung adenocarcinomas and suggest subtype-specific effects of these loci on higher risk of lung cancer in smokers. The CYP2A6 including copy number polymorphism, uninvestigated in large-scale genome-wide association studies, may influence lower risk to heavy tobacco use-related lung cancer.展开更多
Tobacco smoking is a risk factor for colorectal cancer and adenomas. To clarify the effect of genetic factors on the risk for tobacco-related colorectal tumors in a Japanese population, we performed a case-control stu...Tobacco smoking is a risk factor for colorectal cancer and adenomas. To clarify the effect of genetic factors on the risk for tobacco-related colorectal tumors in a Japanese population, we performed a case-control study on 300 patients with two or more tumors and 181 healthy controls;all were genotyped for CYP2A6*4, CYP2A6*7 and CYP2A6*9. Cigarette smoking increased colorectal tumor risk (trend-test P ). Current smokers plus ex-smokers (ever-smokers) with the CYP2A6*4/*4 genotype (whole gene deletion) showed the lowest risk among smokers [odds ratio (OR), 0.17;95% confidence interval (CI), 0.05 - 0.62 compared to ever-smokers with the wild-type CYP2A6*1/*1]. When the participants were classified into four phenotype groups based on estimated CYP2A6 activity [i.e., normal (*1/*1), intermediate (heterozygotes for the *1 and a variant allele), slow (heterozygotes and homozygotes for variant alleles except for *4/*4) and poor (*4/*4)], the ORs (95% CIs) in ever-smokers of the normal, intermediate, slow and poor groups were 6.75 (2.73 - 16.76), 4.59 (2.10 - 10.06), 3.89 (1.69 - 8.95) and 1.17 (0.31 - 4.40), respectively, compared with never-smokers with normal CYP2A6 activity. The susceptibility to colorectal tumors was dependent on the predicted phenotype among ever-smokers (trend-test P = 0.015), but not among never-smokers (trend-test P = 0.47). Stratifying the subjects with respect to cumulative tobacco exposure and estimated CYP2A6 activity, we found the highest risk of colorectal tumors in subjects with higher CYP2A6 activity and higher cumulative tobacco exposure (trend-test P = 0.000023);the lowest risk was found in subjects with the lowest estimated CYP2A6 activity independent of tobacco exposure (trend-test P = 1.00). These results suggest that the gene-environment interaction (i.e. , the CYP2A6-smoking interaction) strongly affects the individual susceptibility to tobacco-related colorectal tumors.展开更多
基金This work was partly supported by Japan Agency for Medical Research and Development(Grant Nos.17ck0106364h0003 and 20ck0106543h0001)the Japan Society for the Promotion of Science(Grant No.19H03522).
文摘With the significant advances in cancer genomics using next-generation sequencing technologies,genomic and molecular profilingbased precision medicine is used as a part of routine clinical test for guiding and selecting the most appropriate treatments for individual cancer patients.Although many molecular-targeted therapies for a number of actionable genomic alterations have been developed,the clinical application of such information is still limited to a small proportion of cancer patients.In this review,we summarize the current status of personalized drug selection based on genomic and molecular profiling and highlight the challenges how we can further utilize the individual genomic information.Cancer immunotherapies,including immune checkpoint inhibitors,would be one of the potential approaches to apply the results of genomic sequencing most effectively.Highly cancer-specific antigens derived from somatic mutations,the so-called neoantigens,occurring in individual cancers have been in focus recently.Cancer immunotherapies,which target neoantigens,could lead to a precise treatment for cancer patients,despite the challenge in accurately predicting neoantigens that can induce cytotoxic T cells in individual patients.Precise prediction of neoantigens should accelerate the development of personalized immunotherapy including cancer vaccines and T-cell receptor-engineered T-cell therapy for a broader range of cancer patients.
文摘Recent genome-wide association studies have identified lung cancer susceptibility loci, such as chromosome 5p15 (telomerase reverse transcriptase, TERT and cleft lip and palate transmembrane protein 1-like, CLPTM1L), 15q25 (nicotinic cholinergic receptor α, CHRNA3-CHRNA5), and 3q28 (tumor protein p63, TP63). Replication study was performed to confirm the association of the recently-identified susceptible loci (i.e., TERT-CLPTM1L, CHRNA3-CHRNA5, and TP63) in a total of 1460 male Japanese smokers (885 lung cancer cases and 575 healthy control subjects), which were previously studied for a low odds ratio of impaired or deletion polymorphism in cytochrome P450 2A6 (CYP2A6) for lung cancer risk. The minor allele frequency (0.442) of rs2736100 on 5p15 (TERT) was significantly higher in lung cancer cases than that (0.395) of controls, with an odds ratio of 1.27 (95% CI of 1.07 - 1.50, p = 0.00504). A series of subgroup analyses revealed the significant associations of rs4488809 (TP63, odds ratio of 1.21, p = 0.0422) and rs2736100 (TERT, odds ratio of 1.47, p = 6.40 × 10–5) with the risk of lung adenocarcinoma. No significant association of CHRNA3-CHRNA5 and CLPTM1L was found in this population. The present results support replication of the association of TERT and TP63 loci with lung adenocarcinomas and suggest subtype-specific effects of these loci on higher risk of lung cancer in smokers. The CYP2A6 including copy number polymorphism, uninvestigated in large-scale genome-wide association studies, may influence lower risk to heavy tobacco use-related lung cancer.
文摘Tobacco smoking is a risk factor for colorectal cancer and adenomas. To clarify the effect of genetic factors on the risk for tobacco-related colorectal tumors in a Japanese population, we performed a case-control study on 300 patients with two or more tumors and 181 healthy controls;all were genotyped for CYP2A6*4, CYP2A6*7 and CYP2A6*9. Cigarette smoking increased colorectal tumor risk (trend-test P ). Current smokers plus ex-smokers (ever-smokers) with the CYP2A6*4/*4 genotype (whole gene deletion) showed the lowest risk among smokers [odds ratio (OR), 0.17;95% confidence interval (CI), 0.05 - 0.62 compared to ever-smokers with the wild-type CYP2A6*1/*1]. When the participants were classified into four phenotype groups based on estimated CYP2A6 activity [i.e., normal (*1/*1), intermediate (heterozygotes for the *1 and a variant allele), slow (heterozygotes and homozygotes for variant alleles except for *4/*4) and poor (*4/*4)], the ORs (95% CIs) in ever-smokers of the normal, intermediate, slow and poor groups were 6.75 (2.73 - 16.76), 4.59 (2.10 - 10.06), 3.89 (1.69 - 8.95) and 1.17 (0.31 - 4.40), respectively, compared with never-smokers with normal CYP2A6 activity. The susceptibility to colorectal tumors was dependent on the predicted phenotype among ever-smokers (trend-test P = 0.015), but not among never-smokers (trend-test P = 0.47). Stratifying the subjects with respect to cumulative tobacco exposure and estimated CYP2A6 activity, we found the highest risk of colorectal tumors in subjects with higher CYP2A6 activity and higher cumulative tobacco exposure (trend-test P = 0.000023);the lowest risk was found in subjects with the lowest estimated CYP2A6 activity independent of tobacco exposure (trend-test P = 1.00). These results suggest that the gene-environment interaction (i.e. , the CYP2A6-smoking interaction) strongly affects the individual susceptibility to tobacco-related colorectal tumors.
