胆管癌全身治疗和局部治疗的最新趋势

Pharmaceuticals Pub Date : 2024-07-08 DOI:10.3390/ph17070910
A. Esmail, Mohamed Badheeb, B. Alnahar, Bushray Almiqlash, Yara Sakr, Ebtesam Al-Najjar, Ali Awas, Mohammad Alsayed, Bayan Khasawneh, Mohammed Alkhulaifawi, Amneh Alsaleh, Ala Abudayyeh, Yaser Rayyan, M. Abdelrahim
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引用次数: 0

摘要

胆管癌(CCA)是一种肝脏恶性肿瘤,发病率迅速上升。CCA 在解剖学上分为肝内(iCCA)和肝外(eCCA),又分为肝周(pCCA)和远端(dCCA)亚型,亚洲的发病率较高。尽管CCA非常罕见,但其5年生存率较低,在过去10-20年中仍是原发性肝肿瘤相关死亡的主要原因。系统治疗部分讨论了以吉西他滨为基础的治疗方案,以及以奥沙利铂为基础的治疗方案。二线疗法有限,但可能包括短期输注氟尿嘧啶(FU)加亮菌素(LV)和奥沙利铂。辅助治疗部分讨论了提高术后总生存率(OS)的方法。然而,只有少数 CCA 患者符合手术切除的条件。与辅助疗法相比,针对无法切除病例的新辅助疗法前景看好。吉西他滨和顺铂显示,等待肝移植的患者可能从中获益。此外,还讨论了在联合化疗中加入免疫疗法的问题。我们探讨了 Nivolumab 以及 CAR-T 细胞、TRBAs 和溶瘤病毒等创新方法。我们旨在通过这篇综述全面报告 CCA 的全身和局部治疗方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Recent Trends of Systemic Treatments and Locoregional Therapies for Cholangiocarcinoma
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.
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