Li Jia, Merl Man Yee, Saif Muhammad Wasif
Yale Cancer Center, Yale University School of Medicine, New Haven, CT, USA.
JOP. 2010 Mar 5;11(2):151-3.
Majority of pancreatic cancers are unresectable upon diagnosis. Palliative chemotherapy is usually administered in an attempt of prolonging survival potentially and providing quality of life. Gemcitabine has been the solo player in the field of pancreatic cancer treatment after replacing 5-FU since 1997. How to treat a patient with advanced pancreatic cancer failing to respond or progressing after gemcitabine is a true challenge. No established second-line treatment exists yet. Chinese herbal medicine PHY906 provides cytoprotective effects without dampening the anti-tumor activity of chemotherapeutic agents. Several combinations such as S-1/gemcitabine, GTX, FOLFIRINOX showed promising results in retrospective studies. Among single agents, erlotinib and Src inhibitor failed to show seemingly benefit, while abraxane and pemetrexed deserve further investigation.
大多数胰腺癌在诊断时就无法切除。姑息性化疗通常用于试图潜在地延长生存期并提高生活质量。自1997年取代5-氟尿嘧啶以来，吉西他滨一直是胰腺癌治疗领域的唯一药物。如何治疗在使用吉西他滨后无反应或病情进展的晚期胰腺癌患者是一个真正的挑战。目前尚无既定的二线治疗方案。中药PHY906具有细胞保护作用，且不会削弱化疗药物的抗肿瘤活性。几种联合用药方案，如S-1/吉西他滨、GTX、FOLFIRINOX，在回顾性研究中显示出有前景的结果。在单药治疗中，厄洛替尼和Src抑制剂似乎未显示出益处，而白蛋白结合型紫杉醇和培美曲塞值得进一步研究。
