Chua Yu Jo, Cunningham David
Department of Medicine, Royal Marsden Hospital, Downs Road, Sutton, Surrey SM2 5PT, UK.
Best Pract Res Clin Gastroenterol. 2006 Apr;20(2):327-48. doi: 10.1016/j.bpg.2005.10.003.
Single-agent gemcitabine was established as standard treatment for advanced pancreatic cancer after a superior clinical benefit response was demonstrated in a randomized study comparing it to 5-fluorouracil (FU). Until recently, many subsequent randomized trials of newer, often gemcitabine-based combinations have not been able to show improved survival over gemcitabine. Combination gemcitabine and capecitabine is likely to become the preferred standard treatment, at least in the UK, on the basis of the positive interim results of the UK National Cancer Research Institute (NCRI) randomized study of chemotherapy with this combination. At present, there is no standard second-line treatment for patients who have become refractory to gemcitabine, although a recently reported study has suggested that oxaliplatin with FU and leucovorin is superior to best supportive care in these patients. This article will review and discuss the clinical trials of chemotherapy for this disease, including the more recent trials, which have included the novel targeted agents.
在一项将吉西他滨与5-氟尿嘧啶（FU）进行对比的随机研究中，单药吉西他滨展现出更优的临床获益反应，此后它被确立为晚期胰腺癌的标准治疗方案。直到最近，许多后续针对更新的、通常以吉西他滨为基础的联合用药的随机试验都未能证明其生存期比吉西他滨单药治疗有所改善。基于英国国家癌症研究所（NCRI）对吉西他滨与卡培他滨联合化疗进行的随机研究的阳性中期结果，至少在英国，吉西他滨与卡培他滨联合用药可能会成为首选的标准治疗方案。目前，对于对吉西他滨治疗无效的患者尚无标准的二线治疗方案，不过最近一项报告显示，在这些患者中，奥沙利铂联合FU和亚叶酸钙优于最佳支持治疗。本文将回顾并讨论针对该疾病的化疗临床试验，包括那些纳入了新型靶向药物的最新试验。
