Pei Sung-Nan, Liao Chun-Kai, Chen Yaw-Sen, Tseng Cheng-Hao, Hung Chao-Ming, Chiu Chong-Chi, Hsieh Meng-Che, Tsai Yu-Fen, Liao Hsiu-Yun, Liu Wei-Ching, Rau Kun-Ming
Department of Hematology-Oncology, E-Da Cancer Hospital, Kaohsiung 824, Taiwan.
School of Medicine, College of Medicine, I-Shou University, Kaohsiung 824, Taiwan.
Cancers (Basel). 2021 Jul 29;13(15):3831. doi: 10.3390/cancers13153831.
Biliary tract cancer (BTC) is a heterogenous collection of biliary tract cancer at different primary sites, and the prognosis of advanced BTC is dismal. Systemic chemotherapy with gemcitabine and cisplatin (GC) has been the reference regimen since 2010. How to improve therapeutic effects of GC regimen is an urgent mission at present.
Bevacizumab with a reduced dosage and modified schedule (10 mg/Kg/triweekly, 1 day before GS at the first 2 cycles) was combined with standard GC for patients with advanced BTC. Tumor response was assessed using Response Evaluation Criteria in Solid Tumors version 1.1 every 2 months. Kaplan-Meier curves were estimated for time-to-treatment failure (TTF), progression-free survival (PFS) and overall survival (OS).
A total of thirty cases of advanced BTC accepted this treatment, and the overall response rate (ORR) was 50.0%, and the disease control rate was 80.0% for all patients. The median TTF was 5.8 months, the median PFS was 8.4 months, and the median OS was 13.6 months. Most responses were noted at the first evaluation. Adverse effects (AEs) were mostly tolerable.
After modifying the schedule, adding bevacizumab to a traditional GC regimen could increase the ORR with a shorter time-to-response, a better PFS and OS than GC alone but without the addition of AE. This regimen can be applied to patients with advanced BTC, especially those who are with a big tumor burden and who need a rapid response.
胆道癌（BTC）是不同原发部位胆道癌的异质性集合，晚期BTC的预后很差。自2010年以来，吉西他滨和顺铂（GC）的全身化疗一直是参考方案。如何提高GC方案的治疗效果是目前的一项紧迫任务。
将剂量减少并调整给药方案（10mg/kg，每三周一次，在前两个周期的GS前1天）的贝伐单抗与晚期BTC患者的标准GC联合使用。每2个月使用实体瘤疗效评价标准1.1版评估肿瘤反应。估计治疗失败时间（TTF）、无进展生存期（PFS）和总生存期（OS）的Kaplan-Meier曲线。
共有30例晚期BTC患者接受了该治疗，所有患者的总缓解率（ORR）为50.0%，疾病控制率为80.0%。中位TTF为5.8个月，中位PFS为8.4个月，中位OS为13.6个月。大多数反应在首次评估时出现。不良反应大多可耐受。
调整给药方案后，在传统GC方案中加入贝伐单抗可提高ORR，与单独使用GC相比，反应时间更短，PFS和OS更好，但不增加不良反应。该方案可应用于晚期BTC患者，尤其是那些肿瘤负荷大且需要快速反应的患者。
