The Efficacy and Safety of Hepatic Arterial Infusion Chemotherapy Based on FOLFIRI for Advanced Intrahepatic Cholangiocarcinoma as Second-Line and Successive Treatment: A Real-World Study.
The Efficacy and Safety of Hepatic Arterial Infusion Chemotherapy Based on FOLFIRI for Advanced Intrahepatic Cholangiocarcinoma as Second-Line and Successive Treatment: A Real-World Study.
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DOI：
10.1155/2022/9680933
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发表时间：
2022
影响因子：
2.7
通讯作者：
中科院分区：
文献类型：
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肝内胆管细胞癌（iCCA）是一种预后差且治疗有限的原发性肝脏恶性肿瘤。顺铂联合吉西他滨被用作标准的一线化疗方案;然而，二线和连续治疗仍然没有有力的证据。虽然初步证据表明精确治疗或免疫治疗在一部分患者中起着至关重要的作用，但基因改变率相对较低。在此，我们探讨了在吉西他滨和铂联合靶向和免疫治疗失败后，使用基于FOLFIRI的肝动脉灌注化疗（HAIC）的二线和连续治疗难治性CCA。 纳入了经诊断病理学证实的iCCA晚期患者，这些患者至少在吉西他滨/铂双联治疗和/或其他全身化疗联合靶向治疗和免疫检查点抑制剂治疗后发生进展。所有患者均通过HAIC接受5-氟尿嘧啶/亚叶酸钙联合伊立替康（FOLFIRI）输注，直至疾病进展或出现不可接受的毒性。主要目的是治疗的可行性，次要目的是疾病控制率（DCR）和6个月生存率。 2020年12月至2021年5月期间共入组9例iCCA患者; 2例患者发生远处转移，7例患者发生局部淋巴结转移和门静脉或肝静脉浸润。HAIC在6/9例患者中作为二线治疗，而在3/9例患者中作为第三种或连续治疗。平均HAIC 2.90 ± 1.69个周期。客观缓解率为22.2%，疾病控制率为55.5%（5/9），中位无进展生存期为5个月，6个月生存率为66.7%（6/9）。 我们的研究结果提供了初步证据，HAIC的基础上FOLFIRI方案是有效的，安全的一些患者在以前的治疗后进展。因此，HAIC可能是一种有前途和有价值的补充治疗晚期CCA的二线和连续治疗。否则，HAIC与精准医学的结合可能会提高临床获益（临床注册号：2021BAT4857）。
Intrahepatic cholangiocarcinoma (iCCA) is a primary liver malignancy with a poor prognosis and limited treatment. Cisplatin with gemcitabine is used as the standard first-line chemotherapy regimen; however, there is still no robust evidence for second-line and successive treatments. Although preliminary evidence suggests a vital role of precision therapy or immunotherapy in a subset of patients, the gene alteration rate is relatively low. Herein, we explored the second-line and successive treatments using hepatic arterial infusion chemotherapy (HAIC) based on FOLFIRI after the failure of gemcitabine and platinum combined with target and immunotherapy in refractory CCAs. Advanced patients with iCCAs confirmed by diagnostic pathology, who progressed at least on a gemcitabine/platinum doublet and/or other systemic chemotherapy combined with target therapy and immune checkpoint inhibitor, were included. All patients received infusional 5-fluorouracil/leucovorin with irinotecan (FOLFIRI) via HAIC until progression or unacceptable toxicity. The primary objective was the feasibility of treatment, with secondary objectives of disease control rate (DCR) and 6-month survival rate. A total of 9 iCCA patients treated between Dec 2020 and May 2021 were enrolled; 2 patients suffered from distant metastasis, while 7 had local lymph node metastasis and portal vein or hepatic vein invasion. HAIC was delivered as second-line therapy in 6/9 patients, while a third or successive therapy in 3/9 patients. The patients accepted an average of 2.90 ± 1.69 cycles of HAIC. The objective response rate was 22.2%; the disease control rate was 55.5% (5/9); median progression-free survival was 5 months; and 6-month survival rate was 66.7% (6/9). Our results provide preliminary evidence that HAIC based on FOLFIRI regimen is efficient and safe in some patients progressing after previous treatment. Therefore, HAIC may be a promising and valuable complementary therapy for advanced CCAs as a second-line and successive therapy. Otherwise, the combination of HAIC with precision medicine may improve clinical benefits (clinical registration number: 2021BAT4857).
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DOI：
10.1016/s1470-2045(20)30157-1
发表时间：
2020-06
期刊：
The Lancet. Oncology
影响因子：
--
作者：
Abou-Alfa GK;Macarulla T;Javle MM;Kelley RK;Lubner SJ;Adeva J;Cleary JM;Catenacci DV;Borad MJ;Bridgewater J;Harris WP;Murphy AG;Oh DY;Whisenant J;Lowery MA;Goyal L;Shroff RT;El-Khoueiry AB;Fan B;Wu B;Chamberlain CX;Jiang L;Gliser C;Pandya SS;Valle JW;Zhu AX
通讯作者：
Zhu AX
影响因子：
51.1
作者：
Subbiah, Vivek;Lassen, Ulrik;Wainberg, Zev A.
通讯作者：
Wainberg, Zev A.
影响因子：
6.2
作者：
Goyal, Lipika;Zheng, Hui;Zhu, Andrew X.
通讯作者：
Zhu, Andrew X.
影响因子：
--
作者：
Caparica, Rafael;Lengele, Adrien;Hendlisz, Alain
通讯作者：
Hendlisz, Alain
影响因子：
5.8
作者：
Lee, Valerie;Murphy, Adrian;Diaz, Luis A., Jr.
通讯作者：
Diaz, Luis A., Jr.