Pancreatic cancer is one of the most devastating solid tumors,and it remains one of the most difficult to treat.The treatment of metastatic pancreatic cancer(MPC)is systemic,based on chemotherapy or best supportive ca...Pancreatic cancer is one of the most devastating solid tumors,and it remains one of the most difficult to treat.The treatment of metastatic pancreatic cancer(MPC)is systemic,based on chemotherapy or best supportive care,depending on the performance status of the patient.Two chemotherapeutical regimens have produced substantial benefits in the treatment of MPC:gemcitabine in 1997;and FOLFIRIONOX in 2011.FOLFIRINOX improved the natural history of MPC,with overall survival(OS)of 11.1 mo.Nab-paclitaxel associated with gemcitabine is a newly approved regimen for MPC,with a median OS of 8.6 mo.Despite multiple trials,this targeted therapy was not efficient in the treatment of MPC.Many new molecules targeting the proliferation and survival pathways,immune response,oncofetal signaling and the epigenetic changes are currently undergoing phaseⅠandⅡtrials for the treatment of MPC,with many promising results.展开更多
Biliary tract cancers(BTCs) are highly fatal malignancies, which are often diagnosed at an advanced stage and have relatively poor prognosis.The treatment of patients with advanced BTC is systemic, based on chemothera...Biliary tract cancers(BTCs) are highly fatal malignancies, which are often diagnosed at an advanced stage and have relatively poor prognosis.The treatment of patients with advanced BTC is systemic, based on chemotherapy or best supportive care, depending on their performance status.Despite clinical trials studyingmany chemotherapeutic regimens and targeted therapies for the treatment of BTC, the standard of care for advanced BTC remains the combination of gemcitabine with cisplatin.Many new molecules targeting proliferation and survival pathways, the immune response and angiogenesis are currently undergoing phase Ⅰ and Ⅱ trials for the treatment of advanced BTC with promising results.展开更多
Ampullary carcinoma(AC) is a rare gastrointestinal tumor without clear treatment recommendations.The management of this tumor is usually extrapolated from the treatment of pancreatic,biliary duct and intestinal cancer...Ampullary carcinoma(AC) is a rare gastrointestinal tumor without clear treatment recommendations.The management of this tumor is usually extrapolated from the treatment of pancreatic,biliary duct and intestinal cancers.Few papers have studied the AC as an independent entity and yet succombs to several limitations.These studies were retrospective single institutional experiences with limited sample sizes recruited over a long period of time.Unlike metastatic ACs where chemotherapy is the only recommended option,localized AC once excised may be approached by either chemotherapy alone or concomitant chemoradiation therapy.In this review,we report the overall survival and recurrence factors of more than 1000 patients from all the studies treating exclusively ACs.We also review the medical treatment of this tumor and conclude to the necessity of multi-institutional randomized controlled studies for AC exclusively.展开更多
文摘Pancreatic cancer is one of the most devastating solid tumors,and it remains one of the most difficult to treat.The treatment of metastatic pancreatic cancer(MPC)is systemic,based on chemotherapy or best supportive care,depending on the performance status of the patient.Two chemotherapeutical regimens have produced substantial benefits in the treatment of MPC:gemcitabine in 1997;and FOLFIRIONOX in 2011.FOLFIRINOX improved the natural history of MPC,with overall survival(OS)of 11.1 mo.Nab-paclitaxel associated with gemcitabine is a newly approved regimen for MPC,with a median OS of 8.6 mo.Despite multiple trials,this targeted therapy was not efficient in the treatment of MPC.Many new molecules targeting the proliferation and survival pathways,immune response,oncofetal signaling and the epigenetic changes are currently undergoing phaseⅠandⅡtrials for the treatment of MPC,with many promising results.
文摘Biliary tract cancers(BTCs) are highly fatal malignancies, which are often diagnosed at an advanced stage and have relatively poor prognosis.The treatment of patients with advanced BTC is systemic, based on chemotherapy or best supportive care, depending on their performance status.Despite clinical trials studyingmany chemotherapeutic regimens and targeted therapies for the treatment of BTC, the standard of care for advanced BTC remains the combination of gemcitabine with cisplatin.Many new molecules targeting proliferation and survival pathways, the immune response and angiogenesis are currently undergoing phase Ⅰ and Ⅱ trials for the treatment of advanced BTC with promising results.
文摘Ampullary carcinoma(AC) is a rare gastrointestinal tumor without clear treatment recommendations.The management of this tumor is usually extrapolated from the treatment of pancreatic,biliary duct and intestinal cancers.Few papers have studied the AC as an independent entity and yet succombs to several limitations.These studies were retrospective single institutional experiences with limited sample sizes recruited over a long period of time.Unlike metastatic ACs where chemotherapy is the only recommended option,localized AC once excised may be approached by either chemotherapy alone or concomitant chemoradiation therapy.In this review,we report the overall survival and recurrence factors of more than 1000 patients from all the studies treating exclusively ACs.We also review the medical treatment of this tumor and conclude to the necessity of multi-institutional randomized controlled studies for AC exclusively.
