Xu Jian-Ying, Guan Wen-Long, Lu Shi-Xun, Wei Xiao-Li, Shi Wen-Jie, Ren Chao, Li Yu-Hong, Li Sheng-Ping, Qiu Miao-Zhen, Wang Feng-Hua
Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.
Department of Pathology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.
Clin Med Insights Oncol. 2022 Apr 30;16:11795549221090186. doi: 10.1177/11795549221090186. eCollection 2022.
Pancreatic acinar cell carcinoma (PACC) is rare, and its appropriate treatment remains unknown. We aim to explore the characteristics and optimal treatment of it.
The data on clinicopathologic characteristics, molecular alteration, treatment, and survival of patients diagnosed with PACC at the Sun Yat-sen University Cancer Center from 2005 to 2020 were collected. The optimal treatment was explored by co-analyzing our results and published literatures.
Twenty-two PACC patients were enrolled. Eight of 17 non-metastatic patients received adjuvant chemotherapy. The patients receiving fluoropyrimidine-based regimen (n = 3) had a better median disease-free survival (mDFS) than those with gemcitabine-based regimen (n = 5) (unreached vs 27 months). Eight metastatic patients received first-line chemotherapy. Four patients received second-line chemotherapy. The objective response rate (ORR) of the fluoropyrimidine-based regimen was 85.7% (6/7), much better than that of the gemcitabine-based regimen (0/5). One patient who had responded to the first-line FOLFIRINOX (5-fluorouracil + oxaliplatin + leucovorin + irinotecan) regimen received olaparib as maintenance treatment for 5 months with good tolerance. Thirty-one published literatures, with a total of 86 cases, were included in the co-analysis. The ORR of the first-line fluoropyrimidine-based regimen (n = 47) was higher than that of gemcitabine-based regimen (n = 39) (59.6% vs 15.3%, < .001). Eight of 11 patients treated with the FOLFIRINOX regimen achieved partial response (PR).
For patients with metastasis, a fluorouracil-based regimen such as FOLFIRINOX may be preferred, and maintenance treatment of poly ADP-ribose polymerase (PARP) inhibitors after effective platinum-containing treatment for breast cancer susceptibility gene (BRCA) mutation patients must be assessed.
胰腺腺泡细胞癌（PACC）较为罕见，其恰当的治疗方法尚不明确。我们旨在探究其特征及最佳治疗方案。
收集了2005年至2020年在中山大学肿瘤防治中心确诊为PACC的患者的临床病理特征、分子改变、治疗及生存数据。通过综合分析我们的结果及已发表的文献来探索最佳治疗方案。
纳入了22例PACC患者。17例非转移性患者中有8例接受了辅助化疗。接受氟嘧啶类方案（n = 3）的患者的无病生存期（mDFS）中位数优于接受吉西他滨类方案（n = 5）的患者（未达到中位生存期 vs 27个月）。8例转移性患者接受了一线化疗。4例患者接受了二线化疗。氟嘧啶类方案的客观缓解率（ORR）为85.7%（6/7），远高于吉西他滨类方案（0/5）。1例对一线FOLFIRINOX（5-氟尿嘧啶+奥沙利铂+亚叶酸钙+伊立替康）方案有反应的患者接受了奥拉帕利维持治疗5个月，耐受性良好。共分析纳入了31篇已发表文献，总计86例病例。一线氟嘧啶类方案（n = 47）的ORR高于吉西他滨类方案（n = 39）（59.6% vs 15.3%，P < .001）。11例接受FOLFIRINOX方案治疗的患者中有8例获得部分缓解（PR）。
对于转移性患者，可能首选基于氟尿嘧啶的方案，如FOLFIRINOX，对于乳腺癌易感基因（BRCA）突变患者，在含铂治疗有效后使用聚腺苷二磷酸核糖聚合酶（PARP）抑制剂进行维持治疗必须进行评估。
