文章：

吉西他滨联合顺铂与S-1治疗晚期胆管癌：相较于吉西他滨联合顺铂与度伐利尤单抗的标准治疗方案，更具成本效益且无进展生存期更优

Gemcitabine + Cisplatin + S-1 Treatment for Advanced Cholangiocarcinoma: Cost-Effective, with Better Progression-Free Survival Versus Standard Treatment with Gemcitabine + Cisplatin + Durvalumab

原文发布日期：12 December 2025

DOI: 10.3390/cancers17243971

类型: Article

开放获取: 是

英文摘要：

Objectives: To evaluate the prognosis and costs of gemcitabine + cisplatin + S-1 (GCS) versus gemcitabine + cisplatin + durvalumab (GCD), the standard of care for advanced cholangiocarcinoma, in a prospective observational study.Methods: We enrolled 52 patients who received GCS as first-line treatment from April 2020 to April 2024 and 44 patients who received GCD from March 2023 to April 2024. Overall survival (OS), progression-free survival (PFS) and objective response rate (ORR) were examined. Propensity score matching (PSM) was performed to balance baseline characteristics between the two groups, and OS, PFS and ORR were then analysed in the matched cohorts. Drug costs were compared until the end of treatment.Results: OS was not significantly different between GCS and GCD at 18.6 months (95% confidence interval [CI]: 13.3–21.9) (p= 0.0935) versus 12.2 months (95% CI: 7.5–16). PFS was 10.2 months (95% CI: 6.5–13.8) versus 6.2 months (95% CI: 3.2–8.8) for GCS versus GCD, respectively (p= 0.0151). The ORR was also higher for GCS (36.5%) than for GCD (15.9%) (p= 0.0234). Twenty-seven patients were included in the PSM analysis, which showed no significant differences in OS or ORR, and better PFS for GCS (9.3 months, 95% CI: 7.4–21.1 versus 4.8 months, 95% CI: 2.7–8.8;p= 0.007). The cost of GCS versus GCD was $6350 (95% CI: 2300–9800) versus $97,200 (95% CI: 69,400–138,800) by treatment end (p= 0.0001).Conclusions: GCS was significantly less expensive than GCD and showed comparable OS and better PFS.

摘要翻译： 

目的：在一项前瞻性观察性研究中，评估吉西他滨+顺铂+S-1（GCS）方案与晚期胆管癌标准治疗方案吉西他滨+顺铂+度伐利尤单抗（GCD）的预后及费用差异。 方法：研究纳入2020年4月至2024年4月期间接受GCS一线治疗的52例患者，以及2023年3月至2024年4月期间接受GCD治疗的44例患者。评估指标包括总生存期（OS）、无进展生存期（PFS）和客观缓解率（ORR）。采用倾向评分匹配（PSM）平衡两组基线特征，并在匹配队列中分析OS、PFS和ORR。同时比较两组治疗结束前的药物费用。 结果：GCS组与GCD组的中位OS分别为18.6个月（95%置信区间[CI]：13.3-21.9）和12.2个月（95% CI：7.5-16），差异无统计学意义（p=0.0935）。GCS组中位PFS为10.2个月（95% CI：6.5-13.8），显著优于GCD组的6.2个月（95% CI：3.2-8.8）（p=0.0151）。GCS组ORR为36.5%，高于GCD组的15.9%（p=0.0234）。PSM分析纳入27对匹配患者，结果显示两组OS与ORR无显著差异，但GCS组PFS仍更优（9.3个月对4.8个月，p=0.007）。至治疗结束时，GCS组与GCD组的药物费用分别为6350美元（95% CI：2300-9800）和97200美元（95% CI：69400-138800），差异显著（p=0.0001）。 结论：GCS方案在总生存期相当的情况下，较GCD方案显著降低治疗费用，并展现出更优的无进展生存期。

原文链接：

Gemcitabine + Cisplatin + S-1 Treatment for Advanced Cholangiocarcinoma: Cost-Effective, with Better Progression-Free Survival Versus Standard Treatment with Gemcitabine + Cisplatin + Durvalumab