目前晚期胰腺癌主要将吉西他滨-分子靶向药物-作为一线治疗方案。尚没有与吉西他滨为主的标准的联合化疗方案。但奥沙利铂和5-FU/四氢叶酸都显示了对晚期胰腺癌的疗效[1,2]。目前临床III期实验也支持这些药物的应用[3]。加利福尼亚大学 Margaret Tempero 医生作为NCCN（National Comprehensive Cancer Network）的发言人，也推荐如果吉西他滨治疗失败，将奥沙利铂和氟尿嘧啶作为二线药物用于治疗胰腺癌肝转移[4]。紫杉醇当作为每周节律性化疗时也对胰腺癌有治疗反应[5]，特别是一种被称为蛋白结合型紫杉醇（Nab-paclitaxel是一种新型的蛋白结合型紫杉醇）和阴离子脂质体紫杉醇与吉西他滨联合治疗时[6,7]。 1. DeVita V, Hellman S, Rosenberg S, editors. Cancer: Principles & Practice of Oncology. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2001. Cancers of the gastrointestinal tract, section 4: Cancer of the pancreas; pp. 1149–1150. 2. Louvet C, Labianca R, Hammel P, et al. Gemcitabine in combination with oxaliplatin compared with gemcitabine alone in locally advanced or metastatic pancreatic cancer: results of a GERCOR and GISCAD phase III trial. J Clin Oncol. 2005;23:3509–3516. 3. Pelzer U, Kubica K, Stieler J, et al. A randomized trial in patients with gemcitabine refractory pancreatic cancer: final results of the CONKO 003 study. 2008 ASCO Annual Meeting Proceedings. J Clin Oncol. 2008;26(May 20 suppl):215S. 4. NCCN Announces Updates to Pancreatic Adenocarcinoma Guidelines.”Available at: http://www.nccn.org/about/news/newsinfo.asp?NewsID=205. 5. Oettle H, Arnold D, Esser M, et al. Paclitaxel as weekly second-line therapy in patients with advanced pancreatic carcinoma. Anticancer Drugs. 2000;11:635–638. 6. Van Hoff DD, Ramanathan R, Borad M, et al. SPARC correlation with response to gemcitabine (G) plus nab-paclitaxel (nab-P) in patients with advanced metastatic pancreatic cancer: a phase I/II study. 2009 ASCO Annual Meeting Proceedings. J Clin Oncol. 2009;27(15S):208s. 7. Loehr M, Lilla C, Meyer D, et al. Cationic liposomal paclitaxel in combination with gemcitabine in patients with advanced pancreatic cancer: a phase II trial. 2009 ASCO Annual Meeting Proceedings. J Clin Oncol. 2009;27(15S):208s. |