Low-Dose Continuous 5-Fluorouracil Combined with Leucovorin, nab-Paclitaxel, Oxaliplatin, and Bevacizumab for Patients with Advanced Pancreatic Cancer: A Retrospective Analysis.
Low-Dose Continuous 5-Fluorouracil Combined with Leucovorin, nab-Paclitaxel, Oxaliplatin, and Bevacizumab for Patients with Advanced Pancreatic Cancer: A Retrospective Analysis.
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DOI：
10.1007/s11523-018-0572-3
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发表时间：
2018-08
影响因子：
5.4
通讯作者：
Hines OJ
中科院分区：
文献类型：
--
作者：
Isacoff WH;Reber HA;Bedford R;Hoos W;Rahib L;Upfill-Brown A;Donahue T;Hines OJ
连续输注5-氟尿嘧啶（5 FU）和亚叶酸钙加白蛋白结合型紫杉醇和奥沙利铂已被证明是积极的胰腺癌患者。作为长期低剂量输注，5 FU具有抗血管生成作用，与贝伐单抗具有协同作用。如在乳腺癌的治疗中所示，贝伐单抗和白蛋白结合型紫杉醇也是协同的。在本文中，我们回顾性分析了65例晚期胰腺癌患者的生存率，这些患者接受了低剂量连续（节拍）化疗联合常规抗VEGF治疗。自2008年7月以来，我们通过移动泵使用5 FU（180 mg/m2/d × 14 d）治疗了65例患者。在第1、8和15天给予亚叶酸钙（20 mg/m2 IV）、白蛋白结合型紫杉醇（60 mg/m2）IV 30分钟输注和奥沙利铂（50 mg/m2）IV 60分钟输注。第1天和第15天，贝伐珠单抗（5 mg/kg）IV给药，持续30分钟。每28-35天重复一个周期。有42名女性和23名男性，中位年龄为59岁。46例患者为IV期疾病。中位生存期为19个月，82%的患者生存12个月或更长时间。总有效率为49%。有28例患者接受过既往治疗，其中15例对治疗有反应。52例患者在治疗前CA 19-9升高。其中，21例患者的CA 19-9水平降低了90%或更多。该队列的客观缓解率为71%，中位生存期为27个月。30名患者因疾病进展而停止治疗，另外22名患者因毒性而停止治疗。1例患者在治疗期间死亡。这种非吉西他滨为基础的方案导致更高的反应率和更好的生存率比通常观察到的治疗给予常规给药方案。小剂量持续（节拍疗法）细胞毒化疗联合抗血管生成治疗是安全有效的。
Continuous-infusion 5-fluorouracil (5FU) and calcium leucovorin plus nab-paclitaxel and oxaliplatin have been shown to be active in patients with pancreatic cancer. As a protracted low-dose infusion, 5FU is antiangiogenic, and has synergy with bevacizumab. As shown in the treatment of breast cancer, bevacizumab and nab-paclitaxel are also synergetic. In this paper we retrospectively analyze the survival of 65 patients with advanced pancreatic cancer who were treated with low-dose continuous (metronomic) chemotherapy given in conjunction with conventional anti-VEGF therapy. Since July of 2008, we have treated 65 patients with 5FU (180 mg/m2/day × 14 days) via an ambulatory pump. Calcium leucovorin (20 mg/m2 IV), nab-paclitaxel (60 mg/m2) IV as a 30-min infusion, and oxaliplatin (50 mg/m2) IV as a 60-min infusion were given on days 1, 8, and 15. Bevacizumab (5 mg/kg) IV over 30 min was administered on days 1 and 15. Cycles were repeated every 28–35 days. There were 42 women and 23 men, and the median age was 59 years. Forty-six patients had stage IV disease. The median survival was 19 months, with 82% of patients surviving 12 months or longer. The overall response rate was 49%. There were 28 patients who had received prior treatment, 15 of whom responded to therapy. Fifty-two patients had elevated CA 19-9 prior to treatment. Of these, 21 patients had 90% or greater reduction in CA 19-9 levels. This cohort had an objective response rate of 71% and a median survival of 27 months. Thirty patients stopped treatment due to disease progression, and an additional 22 stopped because of toxicity. One patient died while on therapy. This non-gemcitabine-based regimen resulted in higher response rates and better survival than what is commonly observed with therapy given at conventional dosing schedules. Low-dose continuous (metronomic therapy) cytotoxic chemotherapy combined with antiangiogenic therapy is safe and effective.
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影响因子：
11.5
作者：
Desai, N;Trieu, V;Soon-Shiong, P
通讯作者：
Soon-Shiong, P
影响因子：
11.2
作者：
Hamano, Y;Sugimoto, H;Kalluri, R
通讯作者：
Kalluri, R
影响因子：
9
作者：
Büchler, P;Reber, HA;Hines, OJ
通讯作者：
Hines, OJ
影响因子：
5.8
作者：
Hurwitz, Herbert I.;Tebbutt, Niall C.;Tabernero, Josep
通讯作者：
Tabernero, Josep
影响因子：
45.3
作者：
Burris, HA;Moore, MJ;VanHoff, DD
通讯作者：
VanHoff, DD