转移性或复发性胰腺癌
转移性或复发性胰腺癌一线治疗方案
权威癌症研究机构美国国家癌症研究所 (NCI) 推荐转移性或复发性胰腺癌一线治疗方案:化疗加或不加靶向治疗(多药化疗-厄洛替尼)。
由于姑息性化疗方案的客观缓解率低且疗效有限,所有新诊断的患者都应考虑参加临床试验。与单药吉西他滨相比,多药化疗组合已被证明可延长预后。[ 1-2 ]
化疗加或不加靶向治疗(多药化疗-厄洛替尼)治疗转移性或复发性胰腺癌医学证据
吉西他滨单独与吉西他滨和厄洛替尼相比:加拿大国家癌症研究所进行了一项 III 期试验 ( CAN-NCIC-PA3 [NCT00026338])[3],比较吉西他滨单独与吉西他滨联合厄洛替尼 (100 mg/d) 治疗晚期或转移性胰腺癌。[4][证据级别:1iiA ]
1.厄洛替尼联合吉西他滨单独使用时可适度延长生存期(HR,0.81;95% CI,0.69–0.99; P = .038)。
2.接受厄洛替尼的患者相应的中位生存率为 6.2 个月,而接受安慰剂的患者为 5.9 个月。接受厄洛替尼的患者的 1 年生存率为 23%,而接受安慰剂的患者为 17%。
参考资料:
[1]Burris HA, 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 Clin Oncol 15 (6): 2403-13, 1997.
[2]Pelzer U, Schwaner I, Stieler J, et al.: Best supportive care (BSC) versus oxaliplatin, folinic acid and 5-fluorouracil (OFF) plus BSC in patients for second-line advanced pancreatic cancer: a phase III-study from the German CONKO-study group. Eur J Cancer 47 (11): 1676-81, 2011.
[3]Gemcitabine With/Out Erlotinib in Unresectable Locally Advanced/Metastatic Pancreatic Cancer[NCT00026338].
[4]Moore MJ, Goldstein D, Hamm J, et al.: Erlotinib plus gemcitabine compared with gemcitabine alone in patients with advanced pancreatic cancer: a phase III trial of the National Cancer Institute of Canada Clinical Trials Group. J Clin Oncol 25 (15): 1960-6, 2007.