青少年和年轻人 (AYAs) 占癌症患者的一小部分。 AYA 癌症患者的基因组图谱尚未得到充分研究，基因组匹配治疗的结果仍然很大程度上未知。我们研究了日本 AYA 和老年 (OA) 患者在基因组改变、治疗证据水平和基因组匹配方面的差异不同癌症类型的治疗使用情况。我们还评估了治疗结果。AYA 患者占 876 例病例的 8.3%。微卫星不稳定性高和/或肿瘤突变负担在 AYA 患者中较少见（OA 患者为 1.4%，OA 患者为 7.7%；P = 0.05）。然而，BRCA1 改变在 AYA 乳腺癌患者中更为常见（27.3% 对比 OA 中的 1.7%；P = 0.01），AYA 结直肠癌患者中 MYC 改变也更常见（OA 中分别为 23.5% 对比 5.8%；P = 0.02）和肉瘤（OA 中为 31.3% 对比 3.4%；P = 0.01）。各组间基因组匹配治疗的使用相似，两组的总生存率均趋于改善。然而，在 AYA 患者中，患者数量较少，无法达到统计学意义。综合基因组分析指导的基因组匹配治疗取得了令人鼓舞的结果，AYA 患者的无进展生存期为 9.0 个月，而 OA 患者的无进展生存期为 3.7 个月 (P = 0.59)。我们的研究表明，量身定制的治疗方法可以使癌症患者受益，无论年龄如何。版权所有 © 2024 作者。由爱思唯尔有限公司出版。保留所有权利。

Adolescents and young adults (AYAs) represent a small proportion of patients with cancer. The genomic profiles of AYA patients with cancer are not well-studied, and outcomes of genome-matched therapies remain largely unknown.We investigated differences between Japanese AYA and older adult (OA) patients in genomic alterations, therapeutic evidence levels, and genome-matched therapy usage by cancer type. We also assessed treatment outcomes.AYA patients accounted for 8.3% of 876 cases. Microsatellite instability-high and/or tumor mutation burden was less common in AYA patients (1.4% versus 7.7% in OA; P = 0.05). However, BRCA1 alterations were more common in AYA patients with breast cancer (27.3% versus 1.7% in OA; P = 0.01), as were MYC alterations in AYA patients with colorectal cancer (23.5% versus 5.8% in OA; P = 0.02) and sarcoma (31.3% versus 3.4% in OA; P = 0.01). Genome-matched therapy use was similar between groups, with overall survival tending to improve in both. However, in AYA patients, the small number of patients prevented statistical significance. Comprehensive genomic profiling-guided genome-matched therapy yielded encouraging results, with progression-free survival of 9.0 months in AYA versus 3.7 months in OA patients (P = 0.59).Our study suggests that tailored therapeutic approaches can benefit cancer patients regardless of age.Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.