局部晚期或转移性胆管癌患者的全身治疗 - - 奥地利专家的一致性声明
Hossein Taghizadeh1,2, Angela Djanani3, Wolfgang Eisterer4
1Department of Internal Medicine I, University Hospital St. Pölten, St. Pölten, Austria.
Frontiers in oncology
|September 15, 2023
概括
对于晚期胆管癌,西斯普拉丁/格米西塔加杜尔瓦卢马布是第一线选择. 在一线治疗失败后,建议对向治疗进行分子测试.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 局部晚期或转移性胆管癌呈现出不良的预后.
- 十多年来,西斯platin/gemcitabine一直是标准的第一线治疗.
- 在III期试验中,杜尔瓦卢马布与西斯普拉丁/吉姆西塔结合的疗效在III期试验中得到改善.
研究的目的:
- 审查目前对晚期胆管癌的治疗策略.
- 评估二线化疗和向治疗的疗效.
- 强调分子分析对个性化治疗的重要性.
主要方法:
- 对一线和二线治疗的第三期临床试验数据的审查.
- 对纳米脂质体里诺特干 (Nal-IRI) 加上5-甲 (5-FU) 和白素 (LV) 的证据分析.
- 基于分子标 (MSI-H,IDH1,FGFR2,BRAF V600E,NTRK) 的向治疗选择的评估.
主要成果:
- 西斯普拉丁/吉姆奇塔宾加上杜尔瓦卢马布在一线治疗中表现出改善的结果.
- 福福克斯显示了二线化疗的积极的III期数据.
- 纳米脂质体内氨基酸和5-FU/LV的二线使用有相互矛盾的证据.
- 在存在分子标时,有针对性的疗法优先于二线化疗.
结论:
- 用西斯普拉丁/吉姆西塔宾和杜尔瓦卢马布进行一线治疗,可提高疗效.
- 针对性疗法是患者失败第一线治疗的关键选择,取决于分子点.
- 在治疗开始时进行全面的分子测试对于及时识别可操作目标至关重要.
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