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中华普通外科学文献(电子版) ›› 2016, Vol. 10 ›› Issue (02) : 158 -162. doi: 10.3877/cma.j.issn.1674-0793.2016.02.018

所属专题: 文献

综述

吉西他滨为基础的一线联合疗法治疗胰腺癌研究进展
崔啸晨1, 马志亮1, 王志茹1,()   
  1. 1. 030000 太原,山西医科大学第二医院普外科
  • 收稿日期:2015-07-01 出版日期:2016-04-01
  • 通信作者: 王志茹
  • 基金资助:
    山西省留学人员重点科研资助项目(2010-099)

Development of the gemcitabine-based first-line therapies for pancreatic cancer

Xiaochen Cui1, Zhiliang Ma1, Zhiru Wang1,()   

  1. 1. Department of General Surgery, the Second Hospital of Shanxi Medical Universi-ty, Taiyuan 030001, China
  • Received:2015-07-01 Published:2016-04-01
  • Corresponding author: Zhiru Wang
  • About author:
    Corresponding author: Wang Zhiru, Email:
引用本文:

崔啸晨, 马志亮, 王志茹. 吉西他滨为基础的一线联合疗法治疗胰腺癌研究进展[J/OL]. 中华普通外科学文献(电子版), 2016, 10(02): 158-162.

Xiaochen Cui, Zhiliang Ma, Zhiru Wang. Development of the gemcitabine-based first-line therapies for pancreatic cancer[J/OL]. Chinese Archives of General Surgery(Electronic Edition), 2016, 10(02): 158-162.

胰腺癌早期临床症状不明显,晚期易于发生肝脏等其他组织器官的远处转移,所以预后极差,5年生存率徘徊在4%~6%。手术切除是目前唯一有可能治愈的方式,但大多数患者直到疾病晚期才被发现,已失去了手术机会,手术切除率不足20%。术后并发症及肿瘤的复发使患者的生存状况无显著改观。目前,吉西他滨作为治疗胰腺癌的最佳基础用药,是美国食品药品管理局FDA批准的治疗胰腺癌的一线化疗药物,可以显著延长患者的生存时间。吉西他滨联合其他抗肿瘤药物不仅使其抑癌作用增强,还减少了某些不良反应及耐药性的发生。最新NCCN指南也推荐吉西他滨+白蛋白结合的紫杉醇、吉西他滨+厄洛替尼、吉西他滨+卡培他滨等为治疗胰腺癌一线联合治疗方案。该文通过复习相关文献报道,对以吉西他滨为基础的几种一线联合化疗方案的最新临床研究进展作一综述,以期开阔思路,寻找更好的治疗、研究方案。

Pancreatic cancer is characterized by its insidious onset, which is easy to be present with liver metastasis or other distant organ metastasis at advanced stage, so the prognosis is extremely poor with 5-year survival rate being 4%-6%. Radical resection may be the only curative treatment. How-ever, most patients have lost the chance for surgical resection because of late diagnosis, and the resection rate is less than 20%. What's more, postoperative complications and recurrence make influence on pa-tients' quality of life without significant improvement. For now gemcitabine acting as the gold standard chemotherapy for the treatment of pancreatic cancer, approved by FDA as the first-line chemotherapy drug, can significantly prolong patients' lifetime. Gemcitabine combined with other drugs not only increase the anti-tumor effect, but also decrease the frequency of adverse events and drug resistance. Combination therapy such as gemcitabine+nab-paclitaxel, gemcitabine+erlotinib, gemcitabine+capecitabine have be recommended as the first-line therapy for the treatment of pancreatic cancer by the latest NCCN Guide-lines. This article reviews the most current articles, looking for developments about the gemcitabine-based first-line therapies in order to find better treatment and research strategy of pancreatic cancer.

1
He Y,Zheng R,Li D, et al. Pancreatic cancer incidence and mor-tality patterns in China, 2011[J]. Chin J Cancer Res, 2015, 27(1): 29-37.
2
Wang L,Yang GH,Lu XH, et al. Pancreatic cancer mortality in China (1991-2000)[J]. World J Gastroenterol, 2003, 9(8): 1819-1823.
3
Shaib Y,Davila J,Naumann C, et al. The impact of curative in-tent surgery on the survival of pancreatic cancer patients: a U.S. Population-based study[J]. AM J Gastroenterol, 2007, 102(7): 1377-1382.
4
Burris HA 3rd,Moore MJ,Andersen J, et al. Improvements in survival and clinical benefit with gemcitabine as first-line thera-py for patients with advanced pancreas cancer: a randomized trial[J]. J Clin Oncol, 1997, 15(6): 2403-2413.
5
Steins M,Thomas M,Geissler M. Erlotinib[J]. Recent Results Cancer Res, 2014, 201: 109-123.
6
Moore MJ,Goldstein D,Hamm J, et al. Erlotinib plus gemcitabi-ne compared with gemcitabine alone in patients with advanced pancreatic cancer:a phase Ⅲ Trial of the national Cancer Insti-tute of Canada Clinical Trials Group[J]. J Clin Oncol, 2007, 25(15): 1960-1966.
7
Benavides M,Plazas JG,Guillen C, et al. Gemcitabine(G)/erlo-tinib(E) versus gemcitabine/ erlotinib/ capecitabine(C) in the first-line treatment of patients with metastatic pancreatic cancer (mPC): Efficacy and safety results of a phase Ⅱ b randomized study from the Spanish TTD Collaborative Group[J]. J Clin Oncol, 2014, 32: 5s suppl, abstr 4122.
8
Shultz D,Pai J,Graber MS, et al. A novel biomarker panel exam-ining response to gemcitabine (G) with or without erlotinib (E) for pancreatic cancer (PA) therapy in NCIC clinical trials group PA.3[J]. J Clin Oncol, 2014, 32: 5s suppl, abstr 4133.
9
Shirasaka T,Shimamato Y,Ohshimo H, et al. Development of a novel form of an oral 5-fluorouracil derivative (S-1) directed to the potentiation of the tumor selective cytotoxicity of 5-fluoroura-cil by two biochemical modulators[J]. Anticancer Drugs, 1996, 7(5): 548-557.
10
Tatsumi K,Fukushima M,Shirasaka T, et al. Inhibitory effects of pyrimidine, barbituric acid and pyridine derivatives on 5-fluoro-uracil degradation in rat liver extracts[J]. Jpn J Cancer Res, 1987, 78(7): 748-755.
11
Shirasaka T,Shimamoto Y,Fukushima M. Inhibition by oxonic acid of gastrointestinal toxicity of 5-fluorouracil without loss of its antitumor activity in rats[J]. Cancer Res, 1993, 53(17): 4004-4009.
12
Ueno H,Okusaka T,Furuse J, et al. Multicenter phase II study of gemcitabine and S-1 combination therapy (GS Therapy) in pa-tients with metastatic pancreatic cancer[J]. Jpn J Clin Oncol, 2011, 41(8): 953-958.
13
Ozaka M,Matsumura Y,Ishii H, et al. Randomized phase Ⅱ study of gemcitabine and S-1 combination versus gemcitabine alone in the treatment of unresectable advanced pancreatic can-cer (Japan Clinical Cancer Research Organization PC-01 study)[J]. Cancer Chemother Pharmacol, 2012, 69(5): 1197-1204.
14
Sudo K,Ishihara T,Hirata N, et al. Randomized controlled study of gemcitabine plus S-1 combination chemotherapy versus gem-citabine for unresectable pancreatic cancer[J]. Cancer Chemother Pharmacol, 2014, 73(2):389-396.
15
Maeda A,Boku N,Fukutomi A, et al. Randomized phase Ⅲ trial of adjuvant chemotherapy with gemcitabine versus S-1 in pa-tients with resected pancreatic cancer: Japan Adjuvant Study Group of Pancreatic Cancer (JASPAC-01)[J]. Jpn J Clin Oncol, 2008, 38(3): 227-229.
16
Ueno H,Ioka T,Ikeda M, et al. Randomized phase Ⅲ study of gemcitabine plus S-1, S-1 alone, or gemcitabine alone in pa-tients with locally advanced and metastatic pancreatic cancer in Japan and Taiwan: GEST study[J]. J Clin Oncol, 2013, 31(13): 1640-1648.
18
Hosein PJ,de Lima Lopes G Jr,Pastorini VH, et al. A phaseⅡtri-al of nab-Paclitaxel as second-line therapy in patients with ad-vanced pancreatic cancer[J]. Am J Clin Oncol, 2013, 36(2): 151-156.
19
Von Hoff DD,Ramanathan RK,Borad MJ, et al. Gemcitabine plus nab-paclitaxel is an active regimen in patients with ad-vanced pancreatic cancer: a phase Ⅰ/Ⅱ trial[J]. J Clin Oncol, 2011, 29(34): 4548-4554.
20
Zhang DS,Wang DS,Wang ZQ, et al. Phase Ⅰ/Ⅱ study of albu-min-bound nab-paclitaxel plus gemcitabine administered to Chi-nese patients with advanced pancreatic cancer[J]. Cancer Che-mother Pharmacol, 2013, 71(4): 1065-1072.
21
Von Hoff DD,Ervin T,Arena FP, et al. Increased survival in pan-creatic cancer with nab-paclitaxel plus gemcitabine[J]. N Engl J Med, 2013, 369(18): 1691-1703.
22
Goldstein D,El-Maraghi RH,Hammel P, et al. nab-Paclitaxel plus gemcitabine for metastatic pancreatic cancer: long-term sur-vival from a phase Ⅲ trial[J]. J Natl Cancer Inst, 2015, 107(2). pii: dju413.
23
Courtin A,Richards FM,Bapiro TE, et al. Anti-tumour efficacy of capecitabine in a genetically engineered mouse model of pan-creatic cancer[J]. PLoS One, 2013, 8(6): e67330
24
Choi JG,Seo JH,Oh SC, et al. A phase Ⅱ trial of gemcitabine plus capecitabine for patients with advanced pancreatic cancer[J]. Cancer Res Treat, 2012, 44(2): 127-132.
25
Lim JY,Cho JH,Lee SJ, et al. Gemcitabine combined with capecitabine compared to gemcitabine with or without erlotinib as first-line chemotherapy in patients with advanced pancreatic can-cer[J]. Cancer Res Treat, 2015, 47(2): 266-273.
26
Cunningham D,Chau I,Stocken DD, et al. Phase Ⅲ randomized comparison of gemcitabine versus gemcitabine plus capecitabine in patients with advanced pancreatic cancer[J]. J Clin Oncol, 2009, 27(33): 5513-5518.
27
Herrmann R,Bodoky G,Ruhstaller T, et al. Gemcitabine plus capecitabine compared with gemcitabine alone in advanced pan-creatic cancer: a randomized, multicenter, phase Ⅲ trial of the Swiss Group for Clinical Cancer Research and the Central Euro-pean Cooperative Oncology Group[J]. J Clin Oncol, 2007, 25(16): 2212-2217.
28
Hubner RA,Worsnop F,Cunningham D, et al. Gemcitabine plus capecitabine in unselected patients with advanced pancreatic can-cer[J]. Pancreas, 2013, 42(3): 511-515.
29
张洪军,张兆伟,刘峰,等.姜黄素增强胰腺癌细胞移植瘤对吉西他滨化疗敏感性的实验研究[J/CD].中华临床医师杂志:电子版, 2013, 7(21): 202-206.
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