文章：

日本地区中心关于度伐利尤单抗联合吉西他滨和顺铂治疗晚期胆道癌的初步使用经验

Initial Use Experience of Durvalumab Plus Gemcitabine and Cisplatin for Advanced Biliary Tract Cancer in a Japanese Territory Center

原文发布日期：19 January 2025

DOI: 10.3390/cancers17020314

类型: Article

开放获取: 是

英文摘要：

Background:Biliary tract cancers (BTCs), including gallbladder and bile duct cancers, have a poor prognosis. Recent advances in chemotherapy, such as using targeted drugs for specific gene mutations, have improved outcomes. Gemcitabine plus cisplatin chemotherapy has been the standard of care for the primary treatment of BTCs, but secondary treatment had not been established until recently. In recent years, durvalumab plus gemcitabine and cisplatin (GCD) chemotherapy is emerging as a promising regimen, although more evidence is needed for its effectiveness.Methods:This retrospective single-center study involved 44 patients receiving GCD treatment between January 2023 and March 2024 with a median follow-up of 10 months. Outcomes focused on overall survival (OS), progression-free survival (PFS), response rates, and adverse events (AEs).Results:The overall response rate (ORR) was 23%, and the disease control rate (DCR) was 82%. The overall median OS and PFS were 15.3 and 8.0 months, respectively, with patients receiving primary chemotherapy experiencing longer survival compared to a control group. Patients who did not undergo bile duct drainage had statistically different better OS and PFS. Grade 3 or higher AEs occurred in 54.5% of patients, with neutropenia and biliary infections being common.Conclusions:GCD chemotherapy shows potential as an effective treatment for BTCs. The favorable treatment outcome was the response rate, particularly in primary therapy or those cases with no metastasis. Bile duct management is crucial for improving patient outcomes. GCD chemotherapy has a high response rate, PFS, and OS compared to other forms of chemotherapy.

摘要翻译： 

背景：胆道癌（包括胆囊癌和胆管癌）预后较差。近年来化疗领域取得进展，例如针对特定基因突变使用靶向药物，改善了治疗效果。吉西他滨联合顺铂化疗一直是胆道癌一线治疗的标准方案，但二线治疗方案直至近期尚未确立。近年来，度伐利尤单抗联合吉西他滨与顺铂化疗方案展现出潜力，但其疗效仍需更多证据支持。 方法：这项回顾性单中心研究纳入2023年1月至2024年3月期间接受GCD治疗的44例患者，中位随访时间为10个月。研究终点包括总生存期、无进展生存期、缓解率及不良事件。 结果：总体缓解率为23%，疾病控制率达82%。总中位OS和PFS分别为15.3个月和8.0个月，接受一线化疗的患者较对照组生存期更长。未接受胆管引流患者的OS和PFS在统计学上显著更优。54.5%的患者发生3级及以上不良事件，其中中性粒细胞减少和胆道感染较为常见。 结论：GCD化疗方案可能成为胆道癌的有效治疗选择。该方案在缓解率方面表现良好，尤其在一线治疗或无转移病例中效果显著。胆道管理对改善患者预后至关重要。与其他化疗方案相比，GCD化疗具有更高的缓解率、更长的无进展生存期和总生存期。

原文链接：

Initial Use Experience of Durvalumab Plus Gemcitabine and Cisplatin for Advanced Biliary Tract Cancer in a Japanese Territory Center