Saif Muhammad Wasif
Yale University School of Medicine, Section of Medical Oncology, New Haven, CT 06520, USA.
JOP. 2007 Mar 10;8(2):166-76.
Survival for patients with pancreatic cancer remains abysmal. Standard treatment for resected and locally advanced disease usually consists of 5-fluorouracil (5-FU, either bolus or continuous infusion) and external beam radiation. However, recent studies have shown the role of gemcitabine either used alone or incorporated with 5-FU and external beam radiation in this setting. Gemcitabine and erlotinib (Tarceva) are currently the only standard chemotherapeutic agents approved by FDA for the treatment of advanced pancreatic cancer. Combination chemotherapy trials incorporating gemcitabine with other agents such as 5-FU, oxaliplatin, or capecitabine generally show improved outcomes in objective response rates but with little or no improvement in survival in phase III trials. In this article, the author summarizes the key studies in pancreatic cancer presented at the 2007 Gastrointestinal Cancers Symposium (Orlando, FL, USA; January, 2007). The studies discussed here include preliminary results of the Cancer and Leukemia Group B (CALGB) phase III trial of gemcitabine plus bevacizumab and activity of other targeted agents including sorafenib, cetuximab, retrospective and population-based studies evaluating the role of chemo-radiotherapy and radiotherapy, an analysis of 3,306 patients from the Surveillance, Epidemiology and End Results (SEER) database evaluating the predictive role of lymph nodes in survival following pancreatectomy and the assessment of novel agents, such as Genexol-PM and S-1.
胰腺癌患者的生存率仍然极低。对于可切除及局部晚期疾病的标准治疗通常包括5-氟尿嘧啶（5-FU，推注或持续输注）及外照射放疗。然而，近期研究已显示吉西他滨在这种情况下单独使用或与5-FU及外照射放疗联合使用的作用。吉西他滨和厄洛替尼（特罗凯）是目前美国食品药品监督管理局（FDA）批准用于治疗晚期胰腺癌的仅有的标准化疗药物。将吉西他滨与其他药物如5-FU、奥沙利铂或卡培他滨联合的化疗试验通常在客观缓解率方面显示出改善的结果，但在III期试验中生存率几乎没有或没有提高。在本文中，作者总结了在2007年胃肠道癌症研讨会（美国佛罗里达州奥兰多；2007年1月）上发表的胰腺癌关键研究。这里讨论的研究包括癌症与白血病B组（CALGB）吉西他滨加贝伐单抗III期试验的初步结果以及其他靶向药物的活性，包括索拉非尼、西妥昔单抗，评估放化疗和放疗作用的回顾性及基于人群的研究，对来自监测、流行病学与最终结果（SEER）数据库的3306例患者进行的分析，评估淋巴结在胰腺切除术后生存中的预测作用以及对新型药物如Genexol-PM和S-1的评估。
