伊立替康+卡培他滨+塞来昔布治疗胆管癌治疗方案

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本帖最后由 bluest 于 2011-12-15 11:34 编辑

http://www.asco.org/ASCOv2/Meeti ... mp;abstractID=10202
http://www.asco.org/ASCOv2/Meeti ... mp;abstractID=34172

Background: There is no known effective chemotherapy regimen for patients with unresectable/metastatic cholangiocarcinoma. We are here to report a single institution, retrospective chart review on using a combination of irinotecan, capecitabine, and celecoxib in treating these patients.

Methods: From 9/03 to 11/04, 8 chemotherapy naive patients with a tissue diagnosis of unresectable/ cholangiocarcinoma were seen and treated with a regimen consisting of irinotecan 120mg/m2 on D1, capecitabine 1500mg/m2 D1-14 and celecoxib 200mg bid daily, Q21 days.

Results: Six females and two males, age 56-63 (median age=60), performance status(PS) between 0-2. A total of 64 treatments were given. Baseline CA 19-9 ranged from 86.9 - 6068 u/ml (normal < 33). 7 patients evaluable for CA19-9 response and treatment toxicity. A decline in CA19-9 was seen in 100% (5/7 > 80% decline). CT scan: 2/7 had stable disease and 2/7 had a minimum response (<20% decrease in target tumor size). Toxicity: diarrhea: 5/7 grade 0, 2/7 grade 1; hand-foot syndrome: 6/7 grade 0, 1/7 grade 1; anemia: 1/7 grade 0, 4/7 grade 1, 2/7 grade 2; neutropenia: 4/7 grade 0, 1/7 grade 1, 2/7 grade 2. No other grade III/IV non-hematological toxicity. All patients were alive as of 12/09/04 (1 - 15 months from initiation of treatment). Two patients remain working full time. Median response duration and median survival data have not matured.

Conclusions: XIC is well tolerated in patients with unresectable/metastatic cholangiocarcinoma and provides good palliative effects. A prospective phase II trial study with a dose-escalating scheme for irinotecan and quality of life assessment is being planned.

CA19-9 (u/ml) responses of the five patients in cohort B
患者情况                治疗前                最佳（周期）                结束（周期)
1 转移                   6068.9                544.4 (8)                      838.1 (10)
2 转移                   4253.3                340.7 (11)                      542.8 (15)
3 转移                   135                   20.7 (6)                         22.8 (8)
4 转移                   1362.7                263.9 (5)                      465.7 (10)
5 局部进展             6029.1                3533 (3)                         5770.5 (8)

CA19-9 response among the 7 evaluable patients
患者情况                治疗前                最佳（周期）       下降百分比       结束
1 转移                   6068.9             521.3(12)             91                      521.3
2 转移                   4253.3             340.7(11)             92                      833.4
3 转移                   135                   18.1(12)                87                      18.1
4 转移                   1326.7             263.9(5)                81                      905.7
5 无转移                6029.1             3301.4(9)             46                      10382.9
6 转移                   294.9                259.9(1)                15                      252.9
7 转移                   4120.4             478.6(2)                88                      478.6

二组伊立替康联合卡培他滨和塞来昔布的临床实验，耐受良好，7人组里CT显示2人稳定，2人缩小（幅度低于20%）。最后给出了几个患者治疗前后的CA199数据对比。