Kim Edward J, Semrad Thomas J, Bold Richard J
UC Davis Cancer Center, Division of Hematology and Oncology , Sacramento, CA 95817 , USA.
Expert Opin Investig Drugs. 2015 Jun;24(6):781-94. doi: 10.1517/13543784.2015.1026963. Epub 2015 Mar 25.
Despite some recent advances in treatment options, pancreatic cancer remains a devastating disease with poor outcomes. In a trend contrary to most malignancies, both incidence and mortality continue to rise due to pancreatic cancer. The majority of patients present with advanced disease and there are no treatment options for this stage that have demonstrated a median survival > 1 year. As the penultimate step prior to Phase III studies involving hundreds of patients, Phase II clinical trials provide an early opportunity to evaluate the efficacy of new treatments that are desperately needed for this disease.
This review covers the results of published Phase II clinical trials in advanced pancreatic adenocarcinoma published within the past 5 years. The treatment results are framed in the context of the current standards of care and the historic challenge of predicting Phase III success from Phase II trial results.
Promising therapies remain elusive in pancreatic cancer based on recent Phase II clinical trial results. Optimization and standardization of clinical trial design in the Phase II setting, with consistent incorporation of biomarkers, is needed to more accurately identify promising therapies that warrant Phase III evaluation.
尽管近期在治疗方案方面取得了一些进展,但胰腺癌仍然是一种预后很差的毁灭性疾病。与大多数恶性肿瘤的趋势相反,胰腺癌的发病率和死亡率持续上升。大多数患者就诊时已处于疾病晚期,目前尚无针对该阶段且中位生存期超过1年的治疗方案。作为涉及数百名患者的III期研究之前的倒数第二步,II期临床试验提供了一个早期机会,以评估这种疾病急需的新治疗方法的疗效。
本综述涵盖了过去5年中发表的晚期胰腺腺癌II期临床试验结果。治疗结果是在当前护理标准以及从II期试验结果预测III期试验成功这一历史挑战的背景下进行阐述的。
基于近期II期临床试验结果,胰腺癌中仍未找到有前景的治疗方法。在II期试验中需要优化和标准化临床试验设计,并持续纳入生物标志物,以便更准确地识别有必要进行III期评估的有前景的治疗方法。