Sahlin Marie, Bauden Monika Posaric, Andersson Roland, Ansari Daniel
Department of Surgery, Clinical Sciences Lund, Lund University and Skåne University Hospital, 221 85, Lund, Sweden.
Tumour Biol. 2015 Jun;36(6):4053-62. doi: 10.1007/s13277-015-3479-y. Epub 2015 Apr 30.
Pancreatic cancer is one of the most severe cancers and is predicted to rise up to the number two cancer killer by 2030. The ineffective treatment options available and that the cancer is silent until very late in its course are the main reasons for the poor outcome of the disease. Surgery is the only curative option but only available for 10-15 % of the patients, but even then many relapse due to metastases. Many new treatments are under way, and one of the promising ones is radioimmunotherapy (RIT). This review includes clinical trials with RIT in pancreatic cancer as well as a review of adverse events observed during treatment of other solid tumors. Additionally, preclinical studies are reviewed with emphasis on effect, adverse events, the tumor targeting as well as isotope function. Four clinical trials with pancreatic cancer have been conducted with positive results, and one phase III trial is underway. The use of RIT in patients with solid tumors has proven to be well tolerated, and the adverse effects are almost exclusively hematological. Multiple targets and isotopes have been evaluated preclinically, alone, or in combination with existing drug options. Smaller tumors have in several studies completely regressed, while larger ones have stabilized or progressed more slowly. Pancreatic cancer is one of the solid tumors where RIT have reached the longest. The tumor heterogeneity will most likely leave room for more than one treatment option, and several aspiring therapies are under way. RIT may become part of multimodality tumor-directed therapy for pancreatic cancer.
胰腺癌是最严重的癌症之一，预计到2030年将升至第二大致命癌症。现有的治疗方法效果不佳，且癌症在病程晚期才会出现症状，这些是导致该疾病预后不良的主要原因。手术是唯一的治愈选择，但仅适用于10%-15%的患者，即便如此，许多患者仍会因转移而复发。许多新的治疗方法正在研发中，其中一种有前景的方法是放射免疫疗法（RIT）。这篇综述包括了RIT治疗胰腺癌的临床试验，以及对其他实体瘤治疗过程中观察到的不良事件的综述。此外，还对临床前研究进行了综述，重点关注疗效、不良事件、肿瘤靶向性以及同位素功能。已经进行了四项胰腺癌临床试验，结果均为阳性，一项III期试验正在进行中。事实证明，实体瘤患者对RIT的耐受性良好，不良反应几乎都集中在血液学方面。临床前已经对多种靶点和同位素进行了评估，单独评估或与现有药物联合评估。在多项研究中，较小的肿瘤完全消退，而较大的肿瘤则稳定或进展更为缓慢。胰腺癌是RIT应用取得最长疗效的实体瘤之一。肿瘤异质性很可能为多种治疗选择留出空间，目前有几种有前景的疗法正在研发中。RIT可能会成为胰腺癌多模式肿瘤导向治疗的一部分。
