{"id":24411,"date":"2022-01-12T14:39:45","date_gmt":"2022-01-12T11:39:45","guid":{"rendered":"https:\/\/zdmaa.com\/tumor-mutation-measurement-may-predict-treatment-success\/"},"modified":"2022-01-13T03:06:21","modified_gmt":"2022-01-13T00:06:21","slug":"tumor-mutation-measurement-may-predict-treatment-success","status":"publish","type":"post","link":"https:\/\/zdmaa.com\/fr\/tumor-mutation-measurement-may-predict-treatment-success\/","title":{"rendered":"Mesurer la mutation tumorale peut pr\u00e9dire le succ\u00e8s du traitement"},"content":{"rendered":"<p><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\"><span class=\"\" style=\"vertical-align: inherit;\">Mesurer la mutation tumorale peut pr\u00e9dire le succ\u00e8s du traitement<\/span><\/span><\/span><\/span><\/p>\n<div>\n<p><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">Depuis que la Food and Drug Administration (FDA) des \u00c9tats-Unis a approuv\u00e9 le premier inhibiteur de point de contr\u00f4le, l&rsquo;ipilimumab (Yervoy) <\/span><\/span><sup><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">\u00ae<\/span><\/span><\/sup><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">) en 2011 pour le traitement du cancer de la peau, ces immunoth\u00e9rapies ont b\u00e9n\u00e9fici\u00e9 \u00e0 des patients atteints de cancers de plus en plus vari\u00e9s. <\/span><span style=\"vertical-align: inherit;\">Motiv\u00e9s par le potentiel des m\u00e9dicaments, les cliniciens et les chercheurs explorent de nouvelles fa\u00e7ons de mieux pr\u00e9dire quand un traitement pourrait \u00eatre viable pour un plus grand nombre de cancers et de montrer de meilleurs r\u00e9sultats chez un pourcentage plus \u00e9lev\u00e9 de patients. <\/span><span style=\"vertical-align: inherit;\">L&rsquo;une de ces mesures est ce que les chercheurs appellent le fardeau des mutations tumorales (TMB), qui est bas\u00e9 sur le nombre de mutations de l&rsquo;ADN pr\u00e9sentes dans la tumeur. <\/span><span style=\"vertical-align: inherit;\">Les scientifiques \u00e9tudient des moyens de mesurer le taux m\u00e9tabolique de base comme indicateur potentiel de la r\u00e9ponse du cancer aux inhibiteurs de points de contr\u00f4le. <\/span><span style=\"vertical-align: inherit;\">\u00ab\u00a0Le fardeau des mutations tumorales est un bon moyen d&rsquo;identifier les tumeurs qui peuvent r\u00e9pondre \u00e0 l&rsquo;immunoth\u00e9rapie d&rsquo;une mani\u00e8re qui permet au syst\u00e8me immunitaire d&rsquo;agir contre le cancer\u00a0\u00bb, explique Ashish Sangal, MD, oncologue m\u00e9dical \u00e0 l&rsquo;h\u00f4pital de Phoenix.<\/span><\/span><\/p>\n<p><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">Le cancer se d\u00e9veloppe lorsque l&rsquo;ADN \u00e0 l&rsquo;int\u00e9rieur des cellules change ou mute, emp\u00eachant les cellules de fonctionner correctement. <\/span><span style=\"vertical-align: inherit;\">Dans de nombreux cas, ces mutations peuvent permettre aux cellules d\u00e9fectueuses de se multiplier et de cro\u00eetre, formant des tumeurs. <\/span><span style=\"vertical-align: inherit;\">Les scientifiques pensent que plus le nombre de mutations dans une tumeur est \u00e9lev\u00e9, ou plus le taux m\u00e9tabolique basal est \u00e9lev\u00e9, plus une ou plusieurs de ces mutations sont susceptibles de r\u00e9pondre \u00e0 l&rsquo;immunoth\u00e9rapie.<\/span><\/span><\/span><\/span><\/p>\n<p><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">\u00ab\u00a0Plus il y a de mutations, meilleure est la r\u00e9ponse. Par cons\u00e9quent, plus le nombre de mutations est \u00e9lev\u00e9, plus grandes sont les chances de b\u00e9n\u00e9ficier de l&rsquo;utilisation de l&rsquo;immunoth\u00e9rapie\u00a0\u00bb, explique Ashish Sangal, oncologue m\u00e9dical. <\/span><span style=\"vertical-align: inherit;\">Les m\u00e9dicaments d&rsquo;immunoth\u00e9rapie sont con\u00e7us pour interrompre les signaux qui permettent aux cellules canc\u00e9reuses de se propager. <\/span><span style=\"vertical-align: inherit;\">Se cacher du syst\u00e8me immunitaire. <\/span><span style=\"vertical-align: inherit;\">Les cellules canc\u00e9reuses envoient des signaux d\u00e9licats aux r\u00e9cepteurs de prot\u00e9ines \u00e0 la surface des cellules immunitaires, o\u00f9 elles passent par ce qu&rsquo;on appelle des points de contr\u00f4le immunitaires. <\/span><span style=\"vertical-align: inherit;\">Sans ces points de contr\u00f4le, le syst\u00e8me immunitaire pourrait attaquer les cellules saines. <\/span><span style=\"vertical-align: inherit;\">Deux crit\u00e8res principaux sont utilis\u00e9s pour d\u00e9terminer si un inhibiteur de point de contr\u00f4le peut fonctionner dans un cancer particulier\u00a0:<\/span><\/span><\/p>\n<ul>\n<li><strong><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">PD L1<\/span><\/span><\/strong><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\"> est un r\u00e9cepteur souvent pr\u00e9sent dans les cellules canc\u00e9reuses qui se lie au r\u00e9cepteur PD-1 dans les cellules immunitaires. <\/span><span style=\"vertical-align: inherit;\">Lorsque les deux r\u00e9cepteurs entrent en contact, la cellule canc\u00e9reuse peut envoyer un signal indiquant \u00e0 la cellule immunitaire qu&rsquo;il ne s&rsquo;agit pas d&rsquo;une menace, ce qui la pousse \u00e0 partir et \u00e0 rechercher d&rsquo;autres menaces. <\/span><span style=\"vertical-align: inherit;\">Les inhibiteurs de point de contr\u00f4le interrompent ce signal, permettant aux cellules immunitaires de mieux reconna\u00eetre et attaquer les cellules canc\u00e9reuses.<\/span><\/span><\/li>\n<li><strong><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">L&rsquo;instabilit\u00e9 des microsatellites (MSI)<\/span><\/span><\/strong><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\"> est une mutation g\u00e9n\u00e9tique qui rend difficile la r\u00e9paration de l&rsquo;ADN d&rsquo;une cellule, ce qui peut entra\u00eener le type de croissance cellulaire incontr\u00f4l\u00e9e qui provoque la formation et la croissance de nombreuses tumeurs. <\/span><span style=\"vertical-align: inherit;\">La recherche a montr\u00e9 que les tumeurs avec un MSI \u00e9lev\u00e9 peuvent mieux r\u00e9pondre aux inhibiteurs de point de contr\u00f4le. <\/span><span style=\"vertical-align: inherit;\">L&rsquo;ann\u00e9e derni\u00e8re, la Food and Drug Administration (FDA) des \u00c9tats-Unis a franchi une \u00e9tape cruciale en approuvant le m\u00e9dicament anticanc\u00e9reux pembrolizumab (Keytruda). <\/span><\/span><sup><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">\u00ae<\/span><\/span><\/sup><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\"> ) pour le traitement des cancers \u00e0 haute teneur en MSI. <\/span><span style=\"vertical-align: inherit;\">La premi\u00e8re approbation d&rsquo;un traitement contre le cancer n&rsquo;\u00e9tait pas bas\u00e9e sur l&#8217;emplacement principal de la tumeur dans le corps, mais sur une caract\u00e9ristique g\u00e9n\u00e9tique sp\u00e9cifique trouv\u00e9e dans l&rsquo;ADN du cancer.<\/span><\/span><\/li>\n<\/ul>\n<p><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">Donc, si les cliniciens ont d\u00e9j\u00e0 deux fa\u00e7ons de mesurer le potentiel d&rsquo;un inhibiteur de point de contr\u00f4le, pourquoi en auraient-ils besoin d&rsquo;une autre ? <\/span><span style=\"vertical-align: inherit;\">Les chercheurs pensent que certains cancers qui ne sont pas actuellement trait\u00e9s avec des inhibiteurs de point de contr\u00f4le peuvent avoir un BMR \u00e9lev\u00e9. <\/span><span style=\"vertical-align: inherit;\">De plus, les cellules immunitaires activ\u00e9es ne savent pas toujours quoi attaquer. <\/span><span style=\"vertical-align: inherit;\">La r\u00e9ponse immunitaire est d\u00e9clench\u00e9e lorsque les cellules immunitaires d\u00e9tectent des mol\u00e9cules appel\u00e9es antig\u00e8nes. <\/span><span style=\"vertical-align: inherit;\">Les chercheurs pensent que les cellules canc\u00e9reuses dans les tumeurs avec un taux m\u00e9tabolique basal \u00e9lev\u00e9 peuvent contenir plus de nouveaux antig\u00e8nes, les r\u00e9cepteurs des cellules canc\u00e9reuses qui peuvent attirer les cellules immunitaires.<\/span><\/span><\/p>\n<p><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">Les chercheurs m\u00e8nent plusieurs essais cliniques pour d\u00e9terminer comment le TMB peut \u00eatre utilis\u00e9 pour pr\u00e9dire l&rsquo;efficacit\u00e9 des inhibiteurs de points de contr\u00f4le et d&rsquo;autres traitements contre le cancer. <\/span><span style=\"vertical-align: inherit;\">Les scientifiques travaillent \u00e9galement \u00e0 d\u00e9velopper des moyens fiables pour tester le nombre de mutations pr\u00e9sentes dans le cancer et ce qui pourrait \u00eatre consid\u00e9r\u00e9 comme \u00e9lev\u00e9 par rapport au BMR. <\/span><span style=\"vertical-align: inherit;\">\u00ab\u00a0\u00c0 l&rsquo;avenir, nous arrivons d\u00e9finitivement \u00e0 un point o\u00f9 ces trois \u00e9l\u00e9ments (PD-L1, MSI, charge de mutation tumorale) seront utilis\u00e9s pour aider \u00e0 d\u00e9terminer comment utiliser les immunoth\u00e9rapies et quels types de cancers peuvent r\u00e9pondre ou non\u00a0\u00bb, a d\u00e9clar\u00e9 le Dr .Sangal.<\/span><\/span><\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Mesurer la mutation tumorale peut pr\u00e9dire le succ\u00e8s du traitement Depuis que la Food and Drug Administration (FDA) des \u00c9tats-Unis a approuv\u00e9 le premier inhibiteur de point de contr\u00f4le, l&rsquo;ipilimumab (Yervoy) \u00ae) en 2011 pour le traitement du cancer de la peau, ces immunoth\u00e9rapies ont b\u00e9n\u00e9fici\u00e9 \u00e0 des patients atteints de cancers de plus en &hellip;<\/p>\n","protected":false},"author":1,"featured_media":23266,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[17],"tags":[],"class_list":["post-24411","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-non-classifiee"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Mesurer la mutation 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