Выход
Вход/Login
 
E-mail
Пароль/Password
Забыли пароль?
Введите E-mail и жмите тут. Пароль будет выслан на указанный адрес
Войти (LogIn)

 

Если вы первый раз здесь, то зарегистрируйтесь

Регистрация/Sign Up
Полное имя (Ф И О)/Full name
E-mail
Повторите E-mail
Телефон/Phone
Зарегистрироваться,
на ваш E-mail будет выслан временный пароль

Нажимая кнопку Зарегистрироваться, вы соглашаетесь с Правилами сайта и Политикой Конфиденциальности http://vidar.ru/rules.asp

 

Медицинская литература. Новинки


 

 

 

 

 

 
вce журналы << Анналы хирургической гепатологии << 2023 год << №1 <<
стр.80
отметить
статью

Неоадъювантная химиотерапия при резектабельном раке поджелудочной железы – новый стандарт лечения?

Вервекин И.В., Трушин А.А., Курсенко Р.В., Зайцев Д.А., Захаренко А.А.
Вы можете загрузить полный текст статьи в формате pdf
ФГБОУ ВО “Первый Санкт-Петербургский государственный медицинский университет им. академика И.П. Павлова” Минздрава России; 197022, Санкт-Петербург, ул. Льва Толстого, д. 6-8, Российская Федерация
Адрес для корреспонденции: Вервекин Илья Валерьевич – e-mail: iivervekin@yandex.ru

Цель. Оценка места неоадъювантной химиотерапии при резектабельном раке поджелудочной железы по результатам рандомизированных клинических исследований и метаанализов. Материал и методы. Для поиска литературы использовали базы данных PubMed, Сochrane, EMBASE, GoogleScholar. Ключевые слова MESH “neoadjuvant therapy” в комбинации со словосочетаниями “pancreatic cancer”, “resectable”, “pancreaticoduodenectomy”. Результаты. В начале XXI века представление о биологии рака поджелудочной железы изменилось, и даже на ранних стадиях, при малом размере, отсутствии поражения лимфоузлов опухоль следует считать системным заболеванием. Одним из актуальных вопросов является необходимость применения неоадъювантной полихимиотерапии у больных резектабельными опухолями. Получены доказательства эффективности и безопасности метода. Однако остается ряд вопросов, на которые ответы еще не получены. Станет ли неоадъювантная полихимиотерапия у больных резектабельным раком поджелудочной железы новым достижением химиотерапии и стандартом лечения – вопрос будущих клинических исследований. Заключение. Неоадъювантная полихимиотерапия у больных резектабельным раком поджелудочной железы – перспективный метод лечения, способный улучшить онкологические результаты лечения. Вместе с тем доказательств этому в настоящее время недостаточно.

Ключевые слова:
рак поджелудочной железы, неоадъювантная химиотерапия, резектабельный рак, полихимиотерапия, химиолучевая терапия, отдаленные результаты

Литература:
1. Bray F., Ferlay J., Soerjomataram I., et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J. Clin. 2018; 68 (6): 394-424.
2. Siegel R.L., Miller K.D., Jemal A. Cancer statistics, 2019. CA Cancer J. Clin. 2019; 69 (1): 7-34. https://doi.org/10.3322/caac.21551.
3. Whipple A.O., Parsons W.B., Mullins C.R. Treatment of carcinoma of the ampulla of vater. Ann. Surg. 1935; 102 (4): 763-779.
4. Griffin J.F., Poruk K.E., Wolfgang C.L. Pancreatic cancer surgery: past, present, and future. Chin. J. Cancer Res. 2015; 27 (4): 332-348. https://doi.org/10.3978/j.issn.1000-9604.2015.06.07.
5. Cameron J.L., Riall T.S., Coleman J., et al. One thousand consecutive pancreaticoduodenectomies. Ann. Surg. 2006; 244 (1): 10-15.
6. Neoptolemos J.P., Stocken D.D., Friess H., et al. A randomized trial of chemo- radiotherapy and chemotherapy after resection of pancreatic cancer. N. Engl. J. Med. 2004; 350 (12): 1200-1210.
7. Koshy M.C., Landry J.C., Cavanaugh S.X., et al. A challenge to the therapeutic nihilism of ESPAC-1. Int. J. Radiat. Oncol. Biol. Phys. 2005; 61 (4): 965-966.
8. Oettle H., Neuhaus P., Hochhaus A., et al. Adjuvant chemotherapy with gemcitabine and long-term outcomes among patients with resected pancreatic cancer: the CONKO-001 randomized trial. JAMA. 2013; 310 (14): 1473-1481. https://doi.org/10.1001/jama.2013.279201.
9. Neoptolemos J.P., Palmer D.H., Ghaneh P., et al. Comparison of adjuvant gemcitabine and capecitabine with gemcitabine monotherapy in patients with resected pancreatic cancer (ESPAC-4): a multicentre, open- label, randomised, phase 3 trial. Lancet. 2017; 389 (10073): 1011-1024. https://doi.org/10.1016/S0140-6736(16)32409-6.
10. Sinn M., Bahra M., Liersch T., et al. CONKO-005: Adjuvant therapy in R0 resected pancreatic cancer patients with gemcitabine plus erlotinib versus gemcitabine for 24 weeks - a prospective randomized phase III study. J. Clin.Oncol. 2017; 35 (29): 3330-3337. https://doi.org/10.1200/JCO.2017.72.6463.
11. Uesaka K., Boku N., Fukutomi A., et al. Adjuvant chemotherapy of S-1 versus gemcitabine for resected pancreatic cancer: a phase 3, open-label, randomised, non-inferiority trial (JASPAC 01). Lancet. 2016; 388 (10041): 248-257. https://doi.org/10.1016/S0140-6736(16)30583-9.
12. Conroy T, Hammel P, Hebbar M, et al. FOLFIRINOX or Gemcitabine as Adjuvant Therapy for Pancreatic Cancer. N Engl J Med. 2018 Dec 20;379(25):2395-2406. https://doi.org/10.1056/NEJMoa1809775. PMID: 30575490.
13. Howard T.J., Krug J.E., Yu J., Zyromski N.J., et al. A margin-negative R0 resection accomplished with minimal postoperative complications is the surgeon's contribution to long-term survival in pancreatic cancer. J. Gastrointest. Surg. 2006; 10 (10): 1338-1345; discussion 1345-1346.
14. Benassai G., Mastrorilli M., Quarto G., et al. Survival after pancreaticoduodenectomy for ductal adenocarcinoma of the head of the pancreas. Chir. Ital. 2000; 52 (3): 263-270.
15. Millikan K.W. et al. Prognostic factors associated with resectable adenocarcinoma of the head of the pancreas. (0003-1348 (Print)).
16. Sohn T., Yeo C.J., Cameron J.L., et al. Resected adenocarcinoma of the pancreas - 616 patients: results, outcomes, and prognostic indicators. J. Gastrointest. Surg. 2000; 4 (6): 567-579.
17. Richter A., Niedergethmann M., Sturm J.W., et al. Long-term results of partial pancreatico- duodenectomy for ductal adenocarcinoma of the pancreatic head: 25-Year Experience. World J. Surg. 2003; 27 (3); 324-329.
18. Varadhachary G.R., Tamm E.P., Abbruzzese J.L., et al. Borderline resectable pancreatic cancer: definitions, management, and role of preoperative therapy. Ann. Surg. Oncol. 2006; 13 (8): 1035-1046.
19. Versteijne E, Suker M, Groothuis K, et al. Preoperative Chemoradiotherapy Versus Immediate Surgery for Resectable and Borderline Resectable Pancreatic Cancer: Results of the Dutch Randomized Phase III PREOPANC Trial. J Clin Oncol. 2020 Jun 1;38(16):1763-1773. https://doi.org/10.1200/JCO.19.02274. Epub 2020 Feb 27. PMID: 32105518;PMCID: PMC8265386.
20. Ghaneh P, Palmer DH, Cicconi S, et al. ESPAC-5F: Four-arm, prospective, multicenter, international randomized phase II trial of immediate surgery compared with neoadjuvant gemcitabine plus capecitabine (GEMCAP) or FOLFIRINOX or chemoradiotherapy (CRT) in patients with borderline resectable pancreatic cancer. J Clin Oncol. 2020;38(15;suppl.;abstr 4505). https://doi.org/10.1200/JCO.2020.38.15_suppl.4505
21. Truty M.J., Kendrick M.L., Nagorney D.M., et al. Factors predicting response, perioperative outcomes, and survival following total neoadjuvant therapy for borderline/locally advanced pancreatic cancer. https://doi.org/http://doi.org/10.1097/SLA.0000000000003284.
22. Jang, J.-Y. Oncological Benefits of Neoadjuvant Chemoradiation With Gemcitabine Versus Upfront Surgery in Patients With Borderline Resectable Pancreatic Cancer: A Prospective, Randomized, Open-label, Multicenter Phase 2/3 Trial / J.-Y. Jang, Y. Han, H. Lee, и др. // Annals of Surgery. - 2018. - Vol. 268. - No 2. - P. 215- 222
23. Reni M., Balzano G., Zanon S., et al. Safety and efficacy of preoperative or postoperative chemotherapy for resectable pancreatic adenocarcinoma (PACT-15): a randomised, open-label, phase 2-3 trial. Lancet Gastroenterol Hepatol. 2018; 3(6): 413-423. https://doi.org/10.1016/ S2468-1253(18)30081-5.
24. Motoi F., Kosuge T., Ueno H., et al. Randomized phase II/III trial of neoadjuvant chemotherapy with gemcitabine and S-1 versus upfront surgery for resectable pancreatic cancer (Prep-02/JSAP05). Jpn J Clin Oncol. 2019 Feb 1; 49(2): 190194. https://doi.org/10.1093/jjco/hyy190.
25. Sohal D, Duong MT, Ahmad SA, et al. SWOG S1505: Results of perioperative chemotherapy (peri-op CTx) with mfolfi- rinox versus gemcitabine/nab-paclitaxel (Gem/nabP) for resectable pancreatic ductal adenocarcinoma (PDA). J Clin Oncol. 2020;38(15;suppl;abstr 4504). https://doi.org/10.1200/JCO.2020.38.15_suppl.4504
26. Casadei R, Di Marco M, Ricci C, et al. Neoadjuvant Chemoradiotherapy and Surgery Versus Surgery Alone in Resectable Pancreatic Cancer: A Single-Center Prospective, Randomized, Controlled Trial Which Failed to Achieve Accrual Targets. J Gastrointest Surg. 2015;19(10):1802-1812. https://doi.org/10.1007/s11605-015-2890-4
27. Golcher H, Brunner TB, Witzigmann H, et al. Neoadjuvant chemoradiation therapy with gemcitabine/cisplatin and surgery versus immediate surgery in resectable pancreatic cancer: results of the first prospective randomized phase II trial. Strahlenther Onkol. 2015;191(1):7-16. https://doi.org/10.1007/s00066-014-0737-7
28. Fujii T, Satoi S, Yamada S, et al. Clinical benefits of neoadjuvant chemoradiotherapy for adenocarcinoma of the pancreatic head: an observational study using inverse probability of treatment weighting. J Gastroenterol. 2017;52(1):81-93. https://doi.org/10.1007/s00535-016-1217-x
29. Janssen QP, van Dam JL, Bonsing BA, et al. Total neoadjuvant FOLFIRINOX vs. neoadjuvant gemcitabine-based chemoradiotherapy and adjuvant gemcitabine for resectable and borderline resectable pancreatic cancer (PREOPANC-2 trial): study protocol for a nationwide multicenter randomized controlled trial. BMC Cancer. (2021) 21:300. https://doi.org/10.1186/s12885-021-08031-z
30. Perioperative or Adjuvant mFOLFIRINOX for Resectable Pancreatic Cancer. ClinicalTrials.gov identifier. Available online at: https://clinicaltrials.gov/ct2 show/NCT04927780 (accessed August 1, 2022).
31. Testing the Use of the Usual Chemotherapy Before and After Surgery for Removable Pancreatic Cancer. ClinicalTrials.gov identifier. Available online at: https://clinicaltrials.gov/ct2/show/NCT04340141 (accessed August 1, 2022).
32. Labori KJ, Lassen K, Hoem D, et al. Neoadjuvant chemotherapy versus surgery first for resectable pancreatic cancer (Norwegian Pancreatic Cancer Trial - 1 (NorPACT-1)) - study protocol for a national multicentre randomized controlledtrial. BMC Surg. (2017) 17:94. https://doi.org/10.1186/s12893-017-0291-1
33. Schwarz L, Vernerey D, Bachet JB, et al. Resectable pancreatic adenocarcinoma neo-adjuvant FOLF(IRIN)OX- based chemotherapy - a multicenter, non-comparative, randomized, phase II trial (PANACHE01-PRODIGE48 study). BMC Cancer. (2018) 18:762. https://doi.org/10.1186/s12885-018-4663-4
34. Dhir M, Malhotra GK, Sohal DPS, et al. Neoadjuvant treatment of pancreatic adenocarcinoma: a systematic review and meta-analysis of 5520 patients. World J Surg Oncol. 2017;15(1):183. Published 2017 Oct 10. https://doi.org/10.1186/s12957-017-1240-2

Neoadjuvant chemotherapy for resectable pancreatic cancer: a new standard of care?

Vervekin I.V., Trushin A.A., Kursenko R.V., Zaitsev D.A., Zakharenko A.A.

Aim. To evaluate the potential of neoadjuvant chemotherapy in resectable pancreatic cancer based on the results of randomized clinical trials and meta-analyses. Materials and methods. PubMed, Сochrane, EMBASE, GoogleScholar databases were used for bibliographic search with keywords MESH “neoadjuvanttherapy” in combination with “pancreaticcancer”, “resectable”, “pancreaticoduodenectomy”. Results. At the beginning of the 21st century the understanding of pancreatic cancer biology changed. A tumor should be considered a systemic disease even in its early stages, with small size and without lymph node involvement. The necessity for application of neoadjuvant polychemotherapy in patients with resectable tumors is an important issue. The efficacy and safety of the method has been proved. However, a number of questions are still to be answered. Whether neoadjuvant polychemotherapy in patients with resectable pancreatic cancer will be a new achievement of chemotherapy and the standard of care is a matter for future clinical research. Conclusion. Neoadjuvant polychemotherapy in patients with resectable pancreatic cancer is a promising therapy that can improve oncological outcomes of treatment. However, the evidence for this argument is currently insufficient.

Keywords:
pancreatic cancer, neoadjuvant chemotherapy, resectable cancer, polychemotherapy, chemoradiation, long-term results

Новости   Магазин   Журналы   Контакты   Правила   Доставка   О компании  
ООО Издательский дом ВИДАР-М, 2024