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Lai M, Mu T, Liu M, Hu Q, Li J, Huang T, Li Y, Chen S, Cai L. Personalized therapy guided by longitudinal liquid biopsies for treatment of leptomeningeal disease from lung adenocarcinoma: A case report. Oncol Lett 2024; 28:299. [PMID: 38751754 PMCID: PMC11094582 DOI: 10.3892/ol.2024.14432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 03/20/2024] [Indexed: 05/18/2024] Open
Abstract
Molecular-based targeted therapies have significantly benefited certain patients with cancer; however, those with leptomeningeal disease (LMD) persistently exhibit a poor prognosis and are often excluded from clinical trials. Tumor-derived cell-free (cf)DNA, found in the cerebrospinal fluid (CSF) of patients with LMD, can assist in diagnosis and tracking of disease progression. However, the utilization of CSF to direct targeted cancer therapy has yet to be extensively explored. The present study reported the case of a patient with lung adenocarcinoma and LMD who was monitored by performing a series of liquid biopsies of CSF and blood. Targeted sequencing was performed on cfDNA from the CSF and plasma, and the variant allele frequencies (VAFs) of BRAF and NRAS mutations were assessed and analyzed in conjunction with the clinical presentation of the patient. The patient then underwent serial chemotherapy, radiation therapy, immunotherapy and targeted treatment based on the results of the liquid biopsies. Upon the LMD diagnosis, a BRAF p.V600E mutation was detected in plasma cfDNA. Consequently, the patient was treated with vemurafenib and responded favorably to this consolidation treatment for 13 months. After a relapse in July 2018, both BRAF p.V600E and NRAS p.Q61K mutations were detected in CSF supernatant and sediment cell samples, suggesting drug resistance. Therefore, the treatment strategy for the patient changed to cobimetnib plus vemurafenib. Notably, the changes of VAF in the CSF supernatant samples were associated with the clinical status of the patient. The patient survived for 33 months post-LMD diagnosis. The present case report highlights the potential use of liquid biopsy in personalized therapy, as it was instrumental in informing the combinational treatment plan of the patient, which ultimately proved beneficial.
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Affiliation(s)
- Mingyao Lai
- Department of Oncology, Guangdong Sanjiu Brain Hospital, Guangzhou, Guangdong 510510, P.R. China
| | - Tianhao Mu
- HaploX Biotechnology, Shenzhen, Guangdong 518057, P.R. China
- Department of Biomedical and Health Engineering, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong 440300, P.R. China
| | - Ming Liu
- HaploX Biotechnology, Shenzhen, Guangdong 518057, P.R. China
| | - Qingjun Hu
- Department of Oncology, Guangdong Sanjiu Brain Hospital, Guangzhou, Guangdong 510510, P.R. China
| | - Juan Li
- Department of Oncology, Guangdong Sanjiu Brain Hospital, Guangzhou, Guangdong 510510, P.R. China
| | - Tanxiao Huang
- HaploX Biotechnology, Shenzhen, Guangdong 518057, P.R. China
| | - Yingmei Li
- HaploX Biotechnology, Shenzhen, Guangdong 518057, P.R. China
| | - Shifu Chen
- HaploX Biotechnology, Shenzhen, Guangdong 518057, P.R. China
- Department of Biomedical and Health Engineering, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong 440300, P.R. China
| | - Linbo Cai
- Department of Oncology, Guangdong Sanjiu Brain Hospital, Guangzhou, Guangdong 510510, P.R. China
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Kargbo RB. Potent PROTACs Targeting EGFR Mutants in Drug Discovery. ACS Med Chem Lett 2022; 13:1835-1836. [DOI: 10.1021/acsmedchemlett.2c00459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Indexed: 11/11/2022] Open
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Kargbo R. Therapeutic and Effective CURE-PRO Molecules for E3 Ligase-Mediated Targeted Protein Degradation. ACS Med Chem Lett 2022; 13:1206-1208. [PMID: 35978695 PMCID: PMC9377323 DOI: 10.1021/acsmedchemlett.2c00315] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Indexed: 11/28/2022] Open
Affiliation(s)
- Robert
B. Kargbo
- Usona Institute, 2800 Woods Hollow
Road, Fitchburg, Wisconsin 53711-5300, United
States
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Kargbo RB. Application of Rapidly Accelerating Fibrosarcoma Protein Degraders in Drug Discovery. ACS Med Chem Lett 2022; 13:885-887. [DOI: 10.1021/acsmedchemlett.2c00210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Indexed: 11/29/2022] Open
Affiliation(s)
- Robert B. Kargbo
- Usona Institute, 277 Granada Drive, San Luis Obispo, California 93401-7337, United States
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