Selection and therapeutic effect evaluation of chemotherapy regimens for pancreatic cancer
-
摘要: 胰腺癌是一种恶性程度极高的肿瘤,其治疗极具挑战。近年来发现药物治疗不仅在局部进展期胰腺癌术前及术后辅助治疗中起着举足轻重的作用,同时也是晚期胰腺癌的主要治疗手段,可使胰腺癌患者的生存时间及生活质量得到改善。以吉西他滨、氟尿嘧啶类药物为基础的传统化疗在晚期胰腺癌治疗中疗效有限,目前分子靶向治疗研究已取得了一定的进展。基于胰腺癌诊治相关指南或共识并结合现有胰腺癌治疗领域重要的临床试验研究,阐述了胰腺癌的化疗选择方案及疗效评价,相信随着新药的研发及新技术的应用,未来胰腺癌的治疗一定会有新的突破。Abstract: Pancreatic cancer is a highly malignant tumor and its treatment is still a challenge. Recent studies have shown that medication plays an important role in preoperative and postoperative adjuvant therapy for locally advanced pancreatic cancer and is also a major therapeutic method for advanced pancreatic cancer. It can improve the survival time and quality of life in patients with pancreatic cancer. Traditional chemotherapy regimens based on gemcitabine and fluorouracil have limited effects in the treatment of advanced pancreatic cancer,and studies on molecular targeted therapies have achieved some progress in recent years. With reference to related guidelines or consensus on the diagnosis and treatment of pancreatic cancer and important clinical trials of the treatment of pancreatic cancer,this article elaborates on the selection and therapeutic effect evaluation of chemotherapy regimens for pancreatic cancer. We believe that with the research and development of new drugs and the application of new techniques,the treatment of pancreatic cancer will achieve new breakthroughs in future.
-
Key words:
- pancreatic neoplasms /
- chemotherapy /
- adjuvant
-
[1]SIEGEL RL,MILLER KD,JEMAL A.Cancer statistics,2016[J].CA Cancer J Clin,2016,66(1):7-30. [2]WITKOWSKI ER,SMITH JK,TSENG JF.Outcomes following resection of pancreatic cancer[J].J Surg Oncol,2013,107(1):97-103. [3]NEOPTOLEMOS JP,STOCKEN DD,FRIESS H,et al.A randomized trial of chemoradiotherapy and chemotherapy after resection of pancreatic cancer[J].N Engl J Med,2004,350(12):1200-1210. [4]STOCKEN DD,BUCHLER MW,DERVENIS C,et al.Meta-analysis of randomised adjuvant therapy trials for pancreatic cancer[J].Br J Cancer,2005,92(8):1372-1381. [5]KALSER MH,ELLENBERG SS.Pancreatic cancer.Adjuvant combined radiation and chemotherapy following curative resection[J].Arch Surg,1985,120(8):899-903. [6]BURRIS HA 3rd,MOORE MJ,ANDERSEN J,et al.Improvements in survival and clinical benefit with gemcitabine as first-line therapy for patients with advanced pancreas cancer:a randomized trial[J].J Clin Oncol,1997,15(6):2403-2413. [7]JAVLE M,HSUEH CT.Updates in Gastrointestinal Oncology insights from the 2008 44th annual meeting of the American Society of Clinical Oncology[J].J Hematol Oncol,2009,2:9. [8]OETTLE H,NEUHAUS P,HOCHHAUS A,et al.Adjuvant chemotherapy with gemcitabine and long-term outcomes among patients with resected pancreatic cancer:the CONKO-001 randomized trial[J].JAMA,2013,310(14):1473-1481. [9]MAEDA A,BOKU N,FUKUTOMI A,et al.Randomized phaseⅢtrial of adjuvant chemotherapy with gemcitabine versus S-1 in patients with resected pancreatic cancer:Japan Adjuvant Study Group of Pancreatic Cancer(JASPAC-01)[J].Jpn J Clin Oncol,2008,38(3):227-229. [10]The Chinese Society of Clinical Oncology Pancreatic Cancer Expert Committee.Chinese consensus on pancreatic cancer diagnosis and treatment(2014 version)[J].J Clin Hepatol,2014,30(10):970-980.(in Chinese)中国临床肿瘤学会胰腺癌专家委员会.胰腺癌综合诊治中国专家共识(2014年版)[J].临床肝胆病杂志,2014,30(10):970-980. [11]PALMER DH,STOCKEN DD,HEWITT H,et al.A randomized phase 2 trial of neoadjuvant chemotherapy in resectable pancreatic cancer:gemcitabine alone versus gemcitabine combined with cisplatin[J].Ann Surg Oncol,2007,14(7):2088-2096. [12]National Comprehensive Cancer Network.NCCN clinical practice guidelines in oncology:pancreatic adenocarcinoma(Version 2.2016)[EB/OL].https://www.nccn.org/professionals/physician_gls/pdf/pancreatic.pdf. [13]BIDARD FC,HUGUET F,LOUVET C,et al.Circulating tumor cells in locally advanced pancreatic adenocarcinoma:the ancillary Cir Ce 07study to the LAP 07 trial[J].Ann Oncol,2013,24(8):2057-2061. [14]von HOFF DD,ERVIN T,ARENA FP,et al.Increased survival in pancreatic cancer with nab-paclitaxel plus gemcitabine[J].N Engl J Med,2013,369(18):1691-1703. [15]CONROY T,DESSEIGNE F,YCHOU M,et al.FOLFIRINOXversus gemcitabine for metastatic pancreatic cancer[J].N Engl JMed,2011,364(19):1817-1825. [16]MOORE MJ,GOLDSTEIN D,HAMM J,et al.Erlotinib plus gemcitabine compared with gemcitabine alone in patients with advanced pancreatic cancer:a phaseⅢtrial of the National Cancer Institute of Canada Clinical Trials Group[J].J Clin Oncol,2007,25(15):1960-1966. [17]STRUMBERG D,SCHULTHEIS B,EBERT MP,et al.PhaseⅡ,randomized,double-blind placebo-controlled trial of nimotuzumab plus gemcitabine compared with gemcitabine alone in patients(pts)with advanced pancreatic cancer(PC)[C].ASCO Annual Meeting,2013. [18]KO AH,TEMPERO MA,SHAN YS,et al.A multinational phase2 study of nanoliposomal irinotecan sucrosofate(PEP02,MM-398)for patients with gemcitabine-refractory metastatic pancreatic cancer[J].Br J Cancer,2013,109(4):920-925. [19]WANG-GILLAM A,LI CP,BODOKY G,et al.Nanoliposomal irinotecan with fluorouracil and folinic acid in metastatic pancreatic cancer after previous gemcitabine-based therapy(NAPOLI-1):a global,randomised,open-label,phase 3 trial[J].Lancet,2016,387(10018):545-557.
本文二维码
计量
- 文章访问数: 3327
- HTML全文浏览量: 23
- PDF下载量: 550
- 被引次数: 0