Open DB
cBioportal
TCGA
ctDNA
ctDNA NGS의 종류
- CGP (Comprehensive Genomic Profiling)
- MRD (Minimal residual disease)
- Signatera(by Natera), Guardant Reveal
- 예후 예측에는 evidence가 있지만.. blood를 같이 볼지는 논란
- CED (Circulating DNA “Early Detection” or Cancer Early Detection)
DNA-based Research
Using GWAS
Especially by Radiogenomics Consortium (RGS)
RNA-based research
Radiation sensitivity
Pan-cancer models
Radiation sensitivity index (RSI)
Eschrich et al., IJROBP, 2011
Genomic-adjusted radiation dose
Genomic-adjusted radiation dose (GARD)
물리 선량 -> adjusted by RSI -> GARD (유전체 정보로 조정된 생물학적 유효 선량)
RxRSI
종양 control에 요구되는 GARD = cut-point GARD -> LQ model 적용 -> RxRSI
- lung dose-escalation 을 시험했던 RTOG 는 결과가 실패하였는데, RxRSI 를 기반으로 했더니 어떻더라. virtual clinical trial이라는 한계가 있긴 함
Critics
- Not a disease-specific model
- GARD score is based on LQ model
Cancer-specific models
PORTOS: Prostate Cancer
- Additional validation in another RCT cohorts
- SAKK 09/10 (70 Gy vs. 64 Gy)
- NRG/RTOG 0126 (79.2 Gy vs 70.2 Gy)
- High PORTOS ->
ARTIC: Breast Cancer
- Low ARTIC score -> benefit from RT in LRR