叶黄素
吉西他滨
伊立替康
医学
叶酸
奥沙利铂
胰腺癌
肿瘤科
内科学
氟尿嘧啶
紫杉醇
临床试验
喜树碱
化疗
癌症
结直肠癌
转移
作者
Wonhee Woo,Edward T Carey,Minsig Choi
摘要
Abstract: Pancreatic cancer is a highly lethal disease, where the mortality closely matches increasing incidence. Pancreatic ductal adenocarcinoma (PDAC) is the most common histologic type that tends to metastasize early in tumor progression. For metastatic PDAC, gemcitabine had been the mainstay treatment for the past three decades. The treatment landscape has changed since 2010, and current first-line chemotherapy includes triplet drugs like FOLFIRINOX (folinic acid, 5-fluorouracil, irinotecan, and oxaliplatin), and doublet agents like nab-paclitaxel and gemcitabine. Nanoliposomal encapsulated irinotecan (nal-IRI) was developed as a novel formulation to improve drug delivery, effectiveness, and limit toxicities. Nal-IRI, in combination with leucovorin-modulated fluorouracil (5-FU/LV), was found in a large randomized phase III clinical trial (NAPOLI-1) to significantly improve overall survival in patients who progressed on gemcitabine-based therapy. This review will focus on the value of using nal-IRI, toxicities, recent clinical experiences, and tools to improve patient outcomes in this setting. Keywords: liposomal irinotecan, nal-IRI, pancreatic cancer, pancreatic ductal adenocarcinoma, refractory cancer
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