Javle Milind, Zhao Haitao, Abou-Alfa Ghassan K
Department of Gastrointestinal Oncology, MD Anderson Cancer Center, Houston, TX, USA.
Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.
Chin Clin Oncol. 2019 Aug;8(4):44. doi: 10.21037/cco.2019.08.14.
Gallbladder cancer is an aggressive cancer that continues to be an important health care issue in certain regions of the world such as Southeast Asia and Latin America. Most patients are diagnosed at an advanced, unresectable stage and systemic therapy is their only option. Gallbladder cancer patients have traditionally been included in clinical trials for biliary tract cancer. Thus, systemic chemotherapy options for this cancer are similar to those for cholangiocarcinoma, including gemcitabine and cisplatin in the first line and FOLFOX in the second-line setting. Ongoing phase III clinical trials may change the systemic therapy paradigm for this cancer. Molecular profiling has indicated important genetic differences between gallbladder cancer and cholangio-carcinoma, which affects choice of targeted therapy. Her2/neu amplification, PIK3CA mutations and DNA repair genetic aberrations are relatively frequent and represent actionable targets for this cancer.
胆囊癌是一种侵袭性癌症，在世界某些地区，如东南亚和拉丁美洲，仍然是一个重要的医疗保健问题。大多数患者在晚期被诊断出来，处于不可切除阶段，全身治疗是他们唯一的选择。胆囊癌患者传统上被纳入胆管癌的临床试验。因此，这种癌症的全身化疗方案与胆管癌相似，一线治疗包括吉西他滨和顺铂，二线治疗采用FOLFOX方案。正在进行的III期临床试验可能会改变这种癌症的全身治疗模式。分子谱分析表明胆囊癌和胆管癌之间存在重要的基因差异，这会影响靶向治疗的选择。Her2/neu扩增、PIK3CA突变和DNA修复基因畸变相对常见，是这种癌症的可操作靶点。
