Raising the Bar in Advanced Pancreatic Cancer

IF 0.7 1区历史学 Q1 HISTORY

Oral History Review Pub Date : 2017-01-01 DOI:10.17925/OHR.2017.13.01.19

S. Gill

引用次数: 0

Abstract

P ancreatic cancer remains one of our greatest clinical challenges. In the last 5 years we have witnessed the introduction of new agents into our armamentarium, which has fortunately translated into incremental improvements in overall survival. We have level 1 evidence for the use of FOLFIRINOX and nab-paclitaxel in the first-line setting; however, the generalizability of randomized studies in the second-line setting has been less compelling. The use of oxaliplatin and 5-fluorouracil (5FU) post-gemcitabine progression was shown to improve survival in the CONKO-003 trial but failed to do so in the PANCREOX trial. Nano-liposomal irinotecan in combination with 5FU in pre-treated patients yielded an improved survival in the NAPOLI-1 trial, presenting an option in this setting. However, these trials were largely conducted in an era of first-line gemcitabine monotherapy, which is no longer a standard practice. Better evidence with contemporary first-line regimens is needed in order to define the optimal post-progression strategy in advanced pancreatic cancer.

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提高晚期胰腺癌的标准

胰腺癌仍然是我们最大的临床挑战之一。在过去的5年里，我们见证了新药物的引入，幸运的是，这转化为总体生存率的逐步提高。我们有一级证据证明在一线使用FOLFIRINOX和nab-紫杉醇;然而，随机研究在二线环境中的普遍性一直不那么引人注目。在CONKO-003试验中，在吉西他滨进展后使用奥沙利铂和5-氟尿嘧啶(5FU)被证明可以提高生存率，但在胰岛试验中却没有这样做。在NAPOLI-1试验中，伊立替康纳米脂质体联合5FU治疗前患者的生存率提高，在这种情况下提供了一种选择。然而，这些试验主要是在一线吉西他滨单药治疗的时代进行的，这已不再是一种标准做法。为了确定晚期胰腺癌的最佳进展后策略，需要当代一线治疗方案的更好证据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Oral History Review Multiple-

CiteScore

1.20

自引率

27.30%

发文量

期刊介绍： The Oral History Review, published by the Oral History Association, is the U.S. journal of record for the theory and practice of oral history and related fields. The journal’s primary mission is to explore the nature and significance of oral history and advance understanding of the field among scholars, educators, practitioners, and the general public. The Review publishes narrative and analytical articles and reviews, in print and multimedia formats, that present and use oral history in unique and significant ways and that contribute to the understanding of the nature of oral history and memory. It seeks previously unpublished works that demonstrate high-quality research and that offer new insight into oral history practice, methodology, theory, and pedagogy. Work published in the journal arises from many fields and disciplines, reflecting the interdisciplinary nature of oral history. While based in the U.S., the Review reflects the international scope of the field and encourages work from international authors and about international topics.