晚期胆道系统恶性肿瘤的系统治疗

doi:10.3760/cma.j.cn371439-20200819-00058

摘要/Abstract

摘要：

胆道系统恶性肿瘤发病率逐年升高,对于晚期或不可切除的患者,全身治疗是最主要的治疗手段。吉西他滨联合顺铂仍是晚期一线标准化疗方案,同时吉西他滨联合替吉奥、吉西他滨联合白蛋白结合型紫杉醇亦是一线治疗可选择的方案。研究证实免疫治疗作为后线治疗生存获益优势明显,其中纳武单抗疾病控制率达61%,且中位总生存期超过1年。此外,针对FGFR2、IDH1/2、HER-2等胆道肿瘤主要驱动基因的靶向药物也表现出了良好的抗肿瘤活性,成为晚期胆道肿瘤治疗的研究热点。对晚期胆道肿瘤系统化疗、免疫治疗及分子靶向治疗的研究进展进行总结,可为临床实践提供帮助。

关键词: 胆道肿瘤, 药物疗法, 分子靶向治疗, 免疫治疗

Abstract:

The incidence rate of biliary tract cancer is increasing year by year. Systemic therapy is the most important treatment for patients with advanced or unresectable biliary tract cancer. Gemcitabine combined with cisplatin is still the standard first-line chemotherapy, while gemcitabine combined with TS-1 and gemcitabine combined with nab-paclitaxel are also the first-line treatment options. Studies have confirmed that immunotherapy as a back-line treatment has a significant advantage in survival, and the disease control rate of nivolumab is 61% and the median overall survival is more than 1 year. In addition, targeted drugs targeting FGFR2, IDH1/2, HER-2 and other major driving genes of biliary tract cancer also show good antitumor activity, and become research hotspots in the treatment of advanced biliary tract cancer. Summarizing the research progress of systematic chemotherapy, immunotherapy and molecular targeted therapy for advanced biliary tract cancer can provide help for clinical practice.

Key words: Biliary tract neoplasms, Drug therapy, Molecular targeted therapy, Immunotherapy

龙欣, 吴晗, 彭晋, 周福祥. 晚期胆道系统恶性肿瘤的系统治疗[J]. 国际肿瘤学杂志, 2021, 48(5): 302-307.

Long Xin, Wu Han, Peng Jin, Zhou Fuxiang. Systemic therapy of advanced biliary tract cancer[J]. Journal of International Oncology, 2021, 48(5): 302-307.

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