Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey.
Expert Rev Anticancer Ther. 2023 Mar;23(3):243-256. doi: 10.1080/14737140.2023.2183844. Epub 2023 Mar 1.
There have been significant advances in the treatment of hepatobiliary cancers, especially for advanced-stage disease. However, data is limited for optimal therapy selection in the first line and sequencing of available options.
This review covers the systemic treatment of hepatobiliary cancers with an emphasis on the advanced stage. The previously published and ongoing trials will be discussed to create an algorithm for the current practice and to give future perspectives on how the field could go forward.
While there is no standard-of-care option in the adjuvant treatment of hepatocellular cancer, capecitabine is the standard of care for biliary tract cancer. The efficacy of adjuvant gemcitabine and cisplatin and the added benefit of radiotherapy to chemotherapy are yet to be defined. For the advanced stage, immunotherapy-based combinations became the standard of care for both hepatocellular and biliary tract cancers. The molecularly targeted therapy has profoundly changed the second-line and later treatment for biliary tract cancers, while the optimal second-line treatment for advanced hepatocellular cancer is yet to be defined due to rapid advances in the first-line setting.
肝胆癌的治疗已经取得了重大进展，特别是对于晚期疾病。然而，对于一线治疗和现有治疗方案的选择，数据有限。
本文综述了肝胆癌的系统治疗，重点是晚期疾病。将讨论以前发表的和正在进行的试验，以制定当前实践的算法，并为该领域的未来发展提供展望。
虽然在肝细胞癌的辅助治疗中没有标准的治疗方案，但卡培他滨是胆管癌的标准治疗方案。吉西他滨和顺铂辅助治疗的疗效以及放疗对化疗的额外益处仍有待确定。对于晚期疾病，免疫治疗联合已成为肝细胞癌和胆管癌的标准治疗方案。分子靶向治疗极大地改变了胆管癌的二线及以后的治疗，而由于一线治疗的快速进展，晚期肝细胞癌的最佳二线治疗仍有待确定。
