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胆管癌全身治疗和局部区域治疗的最新趋势

英文原题:The Recent Trends of Systemic Treatments and Locoregional Therapies for Cholangiocarcinoma.

PubMed 2024/07/08(内容时间) Pharmaceuticals (Basel) Q1 · IF 5.7(JCR 2025)

研究概要

尽管罕见,CCA 的 5 年生存率很低,在过去 10-20 年间仍是原发性肝肿瘤相关死亡的主要原因。

中文摘要

胆管癌(CCA)是一种发病率迅速上升的肝脏恶性肿瘤。按解剖部位可分为肝内(iCCA)和肝外(eCCA);肝外型又分为肝门部(pCCA)和远端(dCCA)亚型,亚洲地区发病率较高。虽然CCA较罕见,但其5年生存率低,在过去10~20年间仍是原发性肝肿瘤相关死亡的主要原因。本文系统治疗部分讨论以吉西他滨为基础的一线方案以及奥沙利铂类选择。二线治疗选择有限,但可包括短期输注氟尿嘧啶(FU)联合亚叶酸钙(LV)和奥沙利铂。辅助治疗部分讨论改善术后总生存期(OS)的策略,但只有少数CCA患者适合手术切除。相较辅助治疗,对于不可切除病例,新辅助治疗显示出希望。吉西他滨和顺铂可能使等待肝移植的患者获益。文章还讨论免疫治疗与化疗联合、纳武利尤单抗及CAR-T细胞、TRBA和溶瘤病毒等创新策略。本综述旨在全面介绍CCA的系统性和局部区域治疗。

展开英文摘要原文

Cholangiocarcinoma (CCA) is a hepatic malignancy that has a rapidly increasing incidence. CCA is anatomically classified into intrahepatic (iCCA) and extrahepatic (eCCA), which is further divided into perihilar (pCCA) and distal (dCCA) subtypes, with higher incidence rates in Asia. Despite its rarity, CCA has a low 5-year survival rate and remains the leading cause of primary liver tumor-related death over the past 10-20 years. The systemic therapy section discusses gemcitabine-based regimens as primary treatments, along with oxaliplatin-based options. Second-line therapy is limited but may include short-term infusional fluorouracil (FU) plus leucovorin (LV) and oxaliplatin. The adjuvant therapy section discusses approaches to improve overall survival (OS) post-surgery. However, only a minority of CCA patients qualify for surgical resection. In comparison to adjuvant therapies, neoadjuvant therapy for unresectable cases shows promise. Gemcitabine and cisplatin indicate potential benefits for patients awaiting liver transplantation. The addition of immunotherapies to chemotherapy in combination is discussed. Nivolumab and innovative approaches like CAR-T cells, TRBAs, and oncolytic viruses are explored. We aim in this review to provide a comprehensive report on the systemic and locoregional therapies for CCA.

论文信息

作者
Esmail A、Badheeb M、Alnahar BW、Almiqlash B、Sakr Y、Al-Najjar E、Awas A、Alsayed M
单位
Section of GI Oncology, Houston Methodist Neal Cancer Center, Houston Methodist Hospital, Houston, TX 77030, USA.United States
文献类型
综述
期刊
Pharmaceuticals (Basel, Switzerland)2024 Jul 8
原文标识
PubMed 39065760 · DOI 10.3390/ph17070910