Di Nardo Paola, Garattini Silvio Ken, Torrisi Elena, Fanotto Valentina, Miolo Gianmaria, Buonadonna Angela, Puglisi Fabio
Department of Medical Oncology, CRO Aviano, National Cancer Institute, IRCCS, 33081 Aviano, Italy.
Department of Oncology, ASUFC University Hospital of Udine, 33100 Udine, Italy.
Cancers (Basel). 2022 Mar 15;14(6):1502. doi: 10.3390/cancers14061502.
Small bowel adenocarcinoma (SBA) is a rare disease for which scarce evidence is available. We summarized data available on systemic treatment of advanced SBA.
Scientific literature was evaluated to find phase II or phase III clinical trials on systemic treatment for advanced SBA. MeSH terms were selected and combined for the initial search, then inclusion and exclusion criteria were set in a search protocol. Four medical oncologists looked for evidence on Medline, EMBASE and Cochrane databases. Moreover, abstracts from 2016 to June 2021 from the American Society for Clinical Oncology, European Society for Medical Oncology, Gastrointestinal Cancer Symposium and World Congress on Gastrointestinal Cancer were browsed. The selected studies, matching the inclusion and exclusion criteria, were finally tabulated and analyzed.
The trials finally selected were 18 phase II/III clinical trials. Four small phase II trials support the activity of oxaliplatin-based doublets in first-line treatment (CAPOX and mFOLFOX).
No good level evidence is available on the use of bevacizumab, anti-epidermal growth factor receptor, targeted agents or immunotherapy. First-line treatments are largely derived from colorectal cancer protocols, mainly oxaliplatin-based doublets.
小肠腺癌（SBA）是一种罕见疾病，相关证据稀缺。我们总结了晚期SBA全身治疗的现有数据。
评估科学文献以查找晚期SBA全身治疗的II期或III期临床试验。选择并组合医学主题词进行初始检索，然后在检索方案中设定纳入和排除标准。四位医学肿瘤学家在Medline、EMBASE和Cochrane数据库中查找证据。此外，浏览了2016年至2021年6月美国临床肿瘤学会、欧洲医学肿瘤学会、胃肠道癌症研讨会和世界胃肠道癌症大会的摘要。最终将符合纳入和排除标准的选定研究制成表格并进行分析。
最终选定的试验为18项II/III期临床试验。四项小型II期试验支持以奥沙利铂为基础的双联方案用于一线治疗（CAPOX和mFOLFOX）的活性。
关于使用贝伐单抗、抗表皮生长因子受体、靶向药物或免疫疗法，尚无充分的证据。一线治疗主要源自结直肠癌方案，主要是以奥沙利铂为基础的双联方案。
