Dreyer Chantal, Sablin Marie-Paule, Bouattour Mohamed, Neuzillet Cindy, Ronot Maxime, Dokmak Safi, Belghiti Jacques, Guedj Nathalie, Paradis Valérie, Raymond Eric, Faivre Sandrine
Chantal Dreyer, Marie-Paule Sablin, Mohamed Bouattour, Cindy Neuzillet, Eric Raymond, Sandrine Faivre, Department of Medical Oncology, Beaujon University Hospital (AP-HP - PRES Paris 7 Diderot), 92110 Clichy, France.
World J Hepatol. 2015 Apr 28;7(6):910-5. doi: 10.4254/wjh.v7.i6.910.
Advanced cholangiocarcinoma is associated with poor prognostic survival and has limited therapeutic options available at present. The importance of angiogenesis and expression of pro-angiogenic factors in intrahepatic forms of cholangiocarcinoma suggest that therapies targeting angiogenesis might be useful for the treatment of this disease. Here we report three cases of patients with advanced intrahepatic cholangiocarcinoma progressive after standard chemotherapy and treated with sunitinib 50 mg/d in 6-wk cycles of 4 wk on treatment followed by 2 wk off treatment (Schedule 4/2). In all three patients, sunitinib treatment was associated with a sustained disease control superior to 4 mo, patients achieving either a partial response or stable disease. A reduction in tumor size and density was observed in all cases, suggesting tumor necrosis as a result of sunitinib treatment in these patients. In addition, sunitinib was generally well tolerated and the occurrence of side effects was managed with standard medical interventions, as required. Our results suggest that sunitinib therapy may be associated with favorable outcomes and tolerability in patients with advanced cholangiocarcinoma. Those observations contributed to launch a prospective phase II multicenter trial investigating sunitinib in advanced intrahepatic cholangiocarcinoma (SUN-CK study; NCT01718327).
晚期胆管癌的预后生存较差，目前可用的治疗选择有限。肝内型胆管癌中血管生成及促血管生成因子表达的重要性提示，针对血管生成的治疗可能对该病的治疗有用。在此，我们报告3例晚期肝内胆管癌患者，他们在接受标准化疗后病情进展，接受了舒尼替尼治疗，剂量为50 mg/d，每6周为一个周期，治疗4周，然后停药2周（4/2方案）。在所有3例患者中，舒尼替尼治疗均带来了超过4个月的持续疾病控制，患者达到了部分缓解或疾病稳定。所有病例均观察到肿瘤大小和密度减小，提示这些患者的肿瘤坏死是舒尼替尼治疗的结果。此外，舒尼替尼总体耐受性良好，必要时可通过标准医学干预措施处理副作用的发生。我们的结果提示，舒尼替尼治疗可能使晚期胆管癌患者获得良好疗效和耐受性。这些观察结果促使开展了一项前瞻性II期多中心试验，研究舒尼替尼治疗晚期肝内胆管癌（SUN-CK研究；NCT01718327）。
