The present invention relates to the use of one or more biomarkers to evaluate the likelihood that a rapamycin analog would produce an anti-cancer effect in a subject. It is based, at least in part, on the results of experiments employing an integrated next-generation sequencing approach to interrogate spatially separated tumor specimens from the same individuals to decipher intra-tumor and intertumor heterogeneity and determine the oncogenomic basis of exceptional therapeutic benefit to rapalogs in kidney cancer patients. These experiments implicated loss of function mutations in TSC1 and/or TSC2 and/or gain-of-function of mTOR in therapeutic responsiveness to rapamycin analogs. Accordingly, in non-limiting embodiments, the present invention provides for assay methods and kits for determining the presence of loss of function mutations in TSC1 and/or TSC2 and/or gain-of-function of mTOR, and methods of using such determinations in selecting a therapeutic regimen for a cancer patient and in methods of treating cancer patients. In particular non-limiting embodiments, a plurality of tumor sites are evaluated and the composite effect of the genetic background on mTOR function is assessed.
本发明涉及使用一种或多种
生物标志物来评估
雷帕霉素类似物对受试者产生抗癌效果的可能性。本发明至少部分基于采用综合下一代测序方法的实验结果,该方法可对来自同一个体的空间上分离的肿瘤标本进行检测,以破译肿瘤内和肿瘤间的异质性,并确定
雷帕霉素类似物对肾癌患者产生特殊疗效的肿瘤
基因组学基础。这些实验表明,
TSC1和/或
TSC2的功能缺失突变和/或mTOR的功能增益与
雷帕霉素类似物的治疗反应性有关。因此,在非限制性实施方案中,本发明提供了用于确定
TSC1 和/或
TSC2 和/或 mTOR 功能增益中是否存在功能缺失突变的检测方法和试剂盒,以及在为癌症患者选择治疗方案和治疗癌症患者的方法中使用这种确定方法的方法。在特定的非限制性实施方案中,对多个肿瘤部位进行评估,并评估遗传背景对 mTOR 功能的综合影响。