寻找癌症的指纹
How comprehensive genomic profiling – through tissue and liquid-based approaches – is driving truly personalised cancer care.
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对于癌症患者，个性化护bob投注平台理比以往任何时候都更重要
Some say COVID-19 is an equal-opportunity disease, bringing suffering to all corners of the globe. But the virus does not play fair – it disproportionately preys on the vulnerable, including those with cancer. Liquid biopsies help even the odds.
Time can be a matter of life and death for cancer patients. Early detection and treatment are essential to improve outcomes, and consistent care is crucial. But the pandemic puts cancer patients at increased risk in three ways:
- 去最近的医院可以超过一个day of arduous travel for patients in rural regions, even in normal times. In the early months of the pandemic, access to healthcare changed for nearly everyone, and infrastructures – from transit to healthcare – broke down.
- Lockdowns and overburdened hospitals prevent patients from seeking testing or treatment. Some are simply too scared to go, even if they could.
- For cancer patients – who are immunocompromised – the risk of infection from COVID-19 and other diseases is particularly high, especially in overcrowded spaces.
Since the pandemic, government and academic institutions report massive declines in cancer care globally. One研究表明，在18个国家的近61％的肿瘤学中心报告了在大流行的第一次峰值期间减少了临床活动，并且近三分之二被引用后治疗成为主要问题。
Data presented at the ESMO Virtual Congress 2020, in that same study, shows that treatments most likely to be cancelled or delayed at cancer centres were surgery at 44%, chemotherapy at nearly 26% and radiotherapy at nearly 14%. Palliative (quality of life) care ended earlier in 32% of centres.
常规筛查也暴跌，降低了早期检测的几率，这转化为在稍后阶段诊断的人的生存赔率降低。
Otherstudiessuggest a roughly 80% drop in March and April 2020 in the U.S. alone, in routine screening appointments that could catch new cancers. Anotherpaperestimated that screening for breast, colon and cervical cancer in the U.S. dropped by about 60% from mid-March to mid-June 2020.
“For patients, it's all about time with cancer … in this phase of their disease journey, time matters more than anything.”
寻找有需要的人的解决方案
世界各地的Roche附属公司早期认识到癌症患者在落后于竞争中留下的那些，以打击大流行。bob投注平台他们决心找到新的和创新的帮助。
“The situation in Italy was difficult; it was one of the most hard-hit countries,” says Luca Lattanzi, Brand Manager of Precision Medicine at Roche.
In some ways, it was the perfect storm for the pandemic: The risk of cancer increases with age, and almost a quarter (23.1%) of Italy’s population is estimated to be 65 years and older – the largest percentage of elderly in Europe in 2019. Research shows that coronavirus is more of a threat to older people, who, if they get the disease, are more likely to have a severe case.
“我们从我们自己的场力和医生s that cancer patients in Italy were not always able to go to hospitals to undergo testing or treatments,” Luca says. “The first lockdown was the spark that pushed us to think outside the box and come up with a way to help.”
One of the solutions? A liquid biopsy in the form of a simple blood draw, performed directly in the patient’s home by a traveling nurse. The nurse arrives at a specified time, draws two vials of blood and packages them for courier pickup within four hours. The vials are sent to a special lab, which can test a tumour for genomic alterations, giving the doctor and patient greater insight to target treatment options.
How mobile blood draw works
- Healthcare provider orders the liquid biopsy test; sends privacy consent forms to patient
- Patient signs forms by email or video/audio recording
- 患者信息将上传到安全系统
- 护士到达患者家庭套件和预先印刷的患者形式
- Nurse performs blood draw, fills the box and seals it, and leaves with any biowaste
- The blood sample is refrigerated by the patient and collected by courier within 4 hours.
每个癌症，像每个人一样，是独一无二的
Every person has a unique set of genetic instructions, called a genome. Cancer is a disease of the genome, caused by genomic alterations that make a tumour grow. Comprehensive genomic profiling, or CGP, is a powerful tool for proper diagnosis and treatment planning. It tests a tumour’s DNA for more than 300 genomic alterations, and offers a summary of treatment options based on the alterations identified. This gives the doctor and patient options for care that are tailored to the individual causes of the disease.
可以通过组织活组织检查进行综合基因组分析，其中组织样品取自侵入性，并且必须在医院或诊所进行。液体活组织检查（血液绘制）给予癌症的人是一种微创方式来鉴定靶向癌症治疗。例如，疾病已经进展的肺癌患者可能具有较少可用于活组bob投注平台织检查的组织，或者肿瘤可能在难以达到的位置。
“There’s also the mental side of it,” says says Paulo Neto, Customer Experience Lead for Personalised Healthcare and Foundation Medicine, part of the Roche Group. “People are more comfortable and confident in their homes. So the blood draw is in their own space, their place of shelter. That emotional part is very important; we are coming to them on their terms. We are talking about cancer patients, and many of them are already fragile in their condition.”
什么是液体活组织检查？
Comprehensive genomic profiling with liquid biopsies involves drawing only two vials of blood, and eliminates or minimises time spent in hospitals or clinics. For those who are already weak, it also removes the need to travel long distances for testing. The solution ensures privacy, gives patients safe, timely access to essential diagnostics, and provides invaluable insight to patients and their doctors to help personalise treatment.
How liquid biopsy works
Liquid biopsies test for solid tumours; it detects circulating tumour DNA, shed by the tumour, in the patient’s blood. This opens the option for comprehensive genomic profiling to more patients, regardless of where they are located or the circumstances of the pandemic. Every cancer is unique, and this innovation makes truly personalised cancer care a reality for more patients across the globe.
In just two months, under lockdown conditions and in the midst of pandemic mayhem, the Roche Italy team launched a safe, secure and patient-focused mobile blood draw program that brought liquid biopsy testing to cancer patients in need.
“参与该项目的每个人都知道这个项目的价值和为我们患者提供解决方案的紧迫性，”卢卡说。bob投注平台“社会中的一些最脆弱的人有需要，速度至关重要。但患者隐私和安全性同样重要;这项项目绝对关键。我们很幸运，因为我们依赖于一家专门护士的国家网络，这已经在意大利与我们合作。
Timing is everything
在全球Roche附属公司发起的类似计划。在加拿大和西班牙，医院用Covid-19患者负担过重，患者的访问仅限于立即迫切需要。bob投注平台附属公司与局部输液诊所合作，确保患者可以在全国范围内的网络网络中预约，并在安全，方便的环境中接受液体活组织检查。bob投注平台
bob投注平台患者在线预订测试，并获得快乐的安心，知道快速，微创的测试将最大限度地减少他们感染的风险，并给予他们，以及他们的肿瘤科医生，了解基于疾病进展的个性化治疗决策的见解。
“For patients, it's all about time with cancer,” Paulo says. “Time is really critical for them. And many patients who undergo genomic testing, unfortunately, are in the late stages of disease. So they are looking at this test with the hope that it might open different possibilities. In this phase of their disease journey, time matters more than anything.”
After the pandemic
液体活检计划已经在某些国家已经存在了几年，服务于不容易到达医院或诊所的患者。bob投注平台该解决方案现已在大流行的压力下进行测试，将使患者更好地在未来的选择 - 以及他们的术语，莫罗布洛维利，精密医学客户服务团队协调员。bob投注平台
“I am absolutely convinced this solution can be just as practical in the following years, beyond the pandemic,” Mauro says. “The model in Italy works well; it works well in other places, and we will continue moving it forward. This helps our patients to be safe and to find answers more quickly. It gives us new ways to serve them, and puts the focus on the patient. In the end, that’s our focus, too.
Taking testing to those in need
在印度，大多数人口远离主要医院;大多数在外围地区的高等教育中心寻求治疗。Roche于2017年推出了一项移动血液抽奖计划，以更好地为人口服务。
But COVID-19 brought new challenges in keeping the program running to serve patients. In the early days of the lockdown, there was a lot of uncertainty about COVID-19; tests that required genetic material to be sent outside of the country were deemed “non-essential” by the government, while allowing only “essential” items to be shipped. Test kits – which contained vials of blood destined for genomic testing at a lab – did not clear customs and instead sat idle.
“它是一个震惊;整个程序来到了一个停滞状态，“孟买治疗区域医疗专家-PHC说，Nippun Sandhir说。“但随时干预，该团队能够获得必要的文件，以便在15至20天内允许在印度的测试套件和在实验室的路上。对于我们来说，那些是极端不确定性的日子，我们知道没有选择，而是找一个解决方案。bob投注平台患者依赖它。“
在巴西，在多年前推出的移动血液抽取计划存在巨大差异。该国约有80％的液体活检测试通过移动血液抽取计划进行。
“For some years now, we have the possibility to have home care assistance collect the liquid biopsy,” says Viviane Pinto, Customer Services and Operations Coordinator for Foundation Medicine in São Paulo. “It is an alternative we offer to our patients, and they have the right to choose to either go to a laboratory facility or have a home care nurse complete the procedure. It is a service offered without any additional cost, and even though it is already available for some time, it was specially used during the pandemic in 2020.”
