Chemotherapy for advanced pancreatic cancer
Chemotherapy for advanced pancreatic cancer
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DOI：
10.1016/s0360-3016(03)00448-6
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发表时间：
2003-01-01
影响因子：
7
通讯作者：
Haller, DG
中科院分区：
文献类型：
--
作者：
Haller, DG
实现对晚期胰腺癌的反应和生存率的实质性和有意义的改善已被证明是多年来难以实现的目标。5-基于氟尿嘧啶（5-FU）的化疗通常产生令人沮丧的反应率或改善患者的临床获益，并且试图通过改变5-FU剂量、给药时间表或使用多种药物与5-FU组合来改善这些结果是徒劳的。然而，当吉西他滨首次改善晚期疾病患者的症状控制时，发现了临床获益。在随后的随机试验中，吉西他滨在缓解率、至进展时间和中位生存期方面优于5-FU。这些改善也与临床获益的改善相关。随后的随机III期试验结果表明，与几种单药或联合用药相比，吉西他滨具有生存获益。因此，吉西他滨已成为晚期胰腺癌的事实上的标准治疗，目前的努力旨在寻找可以利用和扩展这些临床益处的策略。(C)2003年爱思唯尔公司
Achieving substantial and meaningful improvements in the response and survival rates for advanced pancreatic cancer has proved to be an elusive goal for many years. 5-Fluorouracil (5-FU)-based chemotherapy has typically produced discouraging response rates or improved clinical benefit for patients, and attempts to improve these results by altering 5-FU dosages, administration schedules, or using a variety of drugs in combination with 5-FU have been unrewarding. A clinical benefit, however, was identified when gemcitabine first generated improvements in symptom control in patients with advanced disease. In a subsequent randomized trial, gemcitabine demonstrated superiority to 5-FU with respect to response rate, time to progression, and median survival. These improvements were also associated with improvement in clinical benefit. The findings of subsequent randomized Phase III trials have suggested a survival benefit for gemcitabine compared with several single agents or combinations. Gemcitabine has thus become the de facto standard of care for advanced pancreatic cancer, and current efforts are directed toward finding strategies that can capitalize on and extend these clinical benefits. (C) 2003 Elsevier Inc.