BRCA 突变的晚期胰腺癌中1L铂类化疗和奥拉帕利维持治疗的安全管理叙述性综述
A narrative review of Safety management of 1 L platinum-based chemotherapy and maintenance olaparib in BRCA mutated advanced pancreatic cancer.
作者信息
Yao Jiayu, Wang Yongchao, Mao Tiebo, Liang Yiyi, Zhang Xiao, Yang Haiyan, Hu Jiong, Jiao Feng, Cui Jiujie, Wang Liwei
机构信息
Department of Oncology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
State Key Laboratory of Oncogene and Related Genes, Shanghai Cancer Institute, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
出版信息
Transl Cancer Res. 2021 May;10(5):2488-2495. doi: 10.21037/tcr-20-3478.
OBJECTIVE
We aimed to review the safety management and efficacy of a modified FOLFIRINOX regimen to help clinicians improve first-line platinum-based chemotherapy and maintenance olaparib to treat patients with advanced PC with BRCA mutations.
BACKGROUND
FOLFIRINOX has relatively high efficacy among all the chemotherapy regimens for advanced pancreatic carcinoma (PC) patients. However, the combination of drugs is often associated with a high incidence of adverse reactions, and safety concerns are the primary reasons limiting its clinical use. In recent years, through the adjustment of drug dosage and administration route, the toxicity of FOLFIRINOX has been reduced while its clinical effect has been maintained. Also, the empirical use of prophylactics in the chemotherapy cycle can reduce chemotherapy-related serious adverse reactions. All these methods have established a good foundation for the maintenance of olaparib.
METHODS
Pubmed, Embase, and the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) were searched using the terms' pancreatic cancer', 'folfirinox', 'parp inhibitor', 'chemotherapy', and 'adverse reaction' from 2005 through to March 2021.
CONCLUSIONS
The historical evidence suggested that modified FOLFIRINOX and maintenance olaparib could significantly improve the therapeutic effect and reduce the toxicity. It also provides some insights for clinicians to choose the most suitable regimen for each patient.
目的
我们旨在回顾改良的FOLFIRINOX方案的安全性管理及疗效，以帮助临床医生改进一线铂类化疗及奥拉帕利维持治疗，用于治疗携带BRCA突变的晚期胰腺癌（PC）患者。
背景
在所有晚期胰腺癌（PC）患者的化疗方案中，FOLFIRINOX具有相对较高的疗效。然而，该药物组合常伴有较高的不良反应发生率，安全性问题是限制其临床应用的主要原因。近年来，通过调整药物剂量及给药途径，FOLFIRINOX的毒性降低，同时维持了其临床效果。此外，在化疗周期中经验性使用预防性药物可减少化疗相关严重不良反应。所有这些方法为奥拉帕利维持治疗奠定了良好基础。
方法
使用“胰腺癌”“FOLFIRINOX”“PARP抑制剂”“化疗”及“不良反应”等检索词，检索2005年至2021年3月期间的PubMed、Embase及美国国立综合癌症网络肿瘤学临床实践指南（NCCN指南®）。
结论
既往证据表明，改良的FOLFIRINOX及奥拉帕利维持治疗可显著提高治疗效果并降低毒性。这也为临床医生为每位患者选择最合适的治疗方案提供了一些见解。
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