JCO:对于晚期胆道癌,三联化疗是否优于二联化疗?

2021-10-19 Nebula MedSci原创

胆道癌(BTC)包括肝门部胆道、肝总管、胆总管区域内的原发性癌肿,是指原发于左右肝管汇合部至胆总管下端的肝外胆道恶性肿瘤。

胆道癌(BTC)包括肝门部胆道、肝总管、胆总管区域内的原发性癌肿,是指原发于左右肝管汇合部至胆总管下端的肝外胆道恶性肿瘤。发病年龄多在50-70岁,但也可见于年轻人。胆道癌的预后总体较差。治疗方式包括手术切除、化疗、放疗以及中医治疗,其中化疗是晚期胆道癌的重要组成部分。对于晚期胆道癌而言,三联化疗是否优于二联化疗尚不清楚。

PRODIGE 38 AMEBICA试验是一项开放标签、随机的II-III期研究,招募了ECOG表现状态0或1分的局部晚期或转移性胆道癌患者,1:1随机分成了两组,接受奥沙利铂、伊立替康和氟尿嘧啶(mFOLFIRINOX)或顺铂和吉西他滨(CISGEM)治疗长达6个月。

本文报道了II期部分的研究结果,主要终点是至少接受了一剂研究治疗的患者6个月时的无进展生存(PFS)率。

两治疗组的PFS和OS

从法国的43个临床中心共招募了191位患者(校正的意向治疗人群 185位:mFOLFIRINOX组 92位,CISGEM组 93位)。中位随访了21个月后,mFOLFIRINOX组和CISGEM组的6个月时的PFS率分别是44.6% (90% CI, 35.7-53.7) 和47.3% (90% CI, 38.4-56.3)。mFOLFIRINOX组和CISGEM组的中位PFS分别是6.2个月 (95% CI, 5.5-7.8) 和 7.4个月(95% CI, 5.6-8.7)。mFOLFIRINOX组和CISGEM组的中位总生存期分别是11.7个月 (95% CI, 9.5-14.2) 和13.8个月(95% CI, 10.9-16.1)。

两治疗组部分副作用发生情况

mFOLFIRINOX组和CISGEM组3级及以上的副作用的发生率分别是72.8%和72.0%(毒性死亡病例:mFOLFIRINOX组 2例,CISGEM组 1例)。

综上所述,在该研究中,mFOLFIRINOX三联化疗方案并没有达到主要研究终点。CISGEM二联化疗方案仍是晚期胆管癌患者的一线标准治疗方案。

原始出处:

Jean marc Phelip, et al. Modified FOLFIRINOX Versus CISGEM Chemotherapy for Patients With Advanced Biliary Tract Cancer (PRODIGE 38 AMEBICA): A Randomized Phase II Study. Journal of Clinical Oncology. October 18, 2021. https://ascopubs.org/doi/full/10.1200/JCO.21.00679

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    2022-04-02 lidong40
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    2022-02-16 医者仁者

    #胆道癌##化疗#,仍然是不得已,现在的#免疫治疗#效果仍然不理想

    0

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    2021-10-21 liucl1027

    学习了

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1891682, encodeId=2acd18916829d, content=<a href='/topic/show?id=25b0102e2df' target=_blank style='color:#2F92EE;'>#JCO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10272, encryptionId=25b0102e2df, topicName=JCO)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6da1120, createdName=lidong40, createdTime=Sat Apr 02 00:39:46 CST 2022, time=2022-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1194246, encodeId=e78d11942465b, content=<a href='/topic/show?id=a9ef83546d6' target=_blank style='color:#2F92EE;'>#胆道癌#</a>用<a href='/topic/show?id=adf23354483' target=_blank style='color:#2F92EE;'>#化疗#</a>,仍然是不得已,现在的<a href='/topic/show?id=daf52906537' target=_blank style='color:#2F92EE;'>#免疫治疗#</a>效果仍然不理想, beContent=null, objectType=article, channel=null, level=null, likeNumber=144, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83546, encryptionId=a9ef83546d6, topicName=胆道癌), TopicDto(id=33544, encryptionId=adf23354483, topicName=化疗), TopicDto(id=29065, encryptionId=daf52906537, topicName=免疫治疗)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=医者仁者, createdTime=Wed Feb 16 22:59:13 CST 2022, time=2022-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1062767, encodeId=b6da1062e67a7, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210827/67aa33f123544d7783feef651faa8f54/5ad2b0b4faf14ebabde1b55f4fe4aa75.jpg, createdBy=5c442478144, createdName=liucl1027, createdTime=Thu Oct 21 23:02:28 CST 2021, time=2021-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1062237, encodeId=a9b6106223e76, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=59c15617193, createdName=ms3000000188065887, createdTime=Wed Oct 20 11:37:57 CST 2021, time=2021-10-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1062153, encodeId=70cc106215374, content=!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7d3a4700555, createdName=595690844, createdTime=Wed Oct 20 07:26:57 CST 2021, time=2021-10-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1062139, encodeId=e88b106213951, content=学习一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b7a31928393, createdName=学医无涯, createdTime=Wed Oct 20 06:04:06 CST 2021, time=2021-10-20, status=1, ipAttribution=)]
    2021-10-20 ms3000000188065887

    学习

    0

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    2021-10-20 595690844

    !!

    0

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    2021-10-20 学医无涯

    学习一下

    0

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