CHICAGO-Neoadjuvant chemotherapy haigone kuenderana nekuvhiyiwa kwepamberi kuti urarame negomarara repancreatic rinogadziriswa, muyedzo mudiki unoratidza.
Zvisingatarisirwi, varwere vakavhiyiwa kekutanga vakararama kwenguva inopfuura gore kupfuura avo vakawana kosi pfupi yeFOLFIRINOX chemotherapy vasati vavhiyiwa.Ichi chigumisiro chinonyanya kushamisa zvakapiwa kuti neoadjuvant therapy yakabatanidzwa nehuwandu hwepamusoro hwekuvhiyiwa kwakashata (R0) uye kuti varwere vakawanda muboka rekurapa vakawana node-negative mamiriro.
"Kuwedzera kwekutevera kunogona kutsanangura zviri nani kukanganisa kwenguva refu kwekuvandudzwa muR0 neN0 muboka reNeoadjuvant," akadaro Knut Jorgen Laborie, MD, University of Oslo, Norway, American Society of Clinical Oncology.ASCO) musangano."Mibairo yacho haitsigire kushandiswa kweneoadjuvant FOLFIRINOX sekurapa kwakajairwa kwegomarara repancreatic."
Ichi chigumisiro chakashamisa Andrew H. Ko, MD, weYunivhesiti yeCalifornia, San Francisco, uyo akakokwa kuhurukuro, uye akabvuma kuti havatsigire neoadjuvant FOLFIRINOX seimwe nzira yekuvhiya mberi.Asi zvakare havaisi kunze mukana uyu.Nekuda kwekufarira chidzidzo ichi, hazvigoneke kutaura chirevo chechokwadi nezveramangwana reFOLFIRINOX neoadjuvant.
Ko akacherechedza kuti hafu chete yevarwere vakapedza maitiro mana e-neoadjuvant chemotherapy, "iyo yakadzikira pane yandaitarisira kuboka iri revarwere, avo maitiro mana ekurapa kazhinji haana kuoma ......Chechipiri, nei Zvine zvimwe zvinofadza zvekuvhiya uye pathologic zvabuda [R0, N0 mamiriro] zvinotungamira kune maitiro akaipisisa muboka reNeoadjuvant?kunzwisisa chikonzero uye pakupedzisira chinja kune gemcitabine-based regimens. "
"Naizvozvo, isu hatigone kuwana mhedziso dzakasimba kubva muchidzidzo ichi nezve kukanganiswa kweFOLFIRINOX pamhedzisiro yekupona ... FOLFIRINOX inoramba iripo, uye zvidzidzo zvakawanda zvirikuenderera mberi zvine tariro yekujekesa kugona kwayo mukuvhiya kusingadzoreki."Zvirwere.”
Laborie akacherekedza kuti kuvhiyiwa kwakasanganiswa neanoshanda systemic kurapa kunopa zvakanakisa mhedzisiro yekenza yepancreatic.Sechinyakare, mwero wekutarisira waisanganisira kuvhiyiwa kwepamberi uye adjuvant chemotherapy.Nekudaro, neoadjuvant therapy inoteverwa nekuvhiyiwa uye adjuvant chemotherapy yatanga kuwana mukurumbira pakati pevazhinji oncologists.
Neoadjuvant therapy inopa akawanda angangoita mabhenefiti: kudzora kwekutanga kwechirwere che systemic, kunatsiridza kuendesa chemotherapy, uye yakagadziridzwa histopathological mhedzisiro (R0, N0), Laborie akaenderera.Nekudaro, kusvika parizvino, hapana muyedzo wakasarudzika wakaratidza zvakajeka kubatsirwa kwekupona kweneoadjuvant chemotherapy.
Kugadzirisa kushaikwa kwedata mumiedzo yakasarudzika, vaongorori kubva kunzvimbo gumi nemaviri muNorway, Sweden, Denmark neFinland vakatsvaga varwere vane rectable pancreatic cancer cancer.Varwere vakarongedzerwa kuenda kumberi kwekuvhiyiwa vakagamuchira 12 mitsetse yeadjuvant-yakagadziridzwa FOLFIRINOX (mFOLFIRINOX).Varwere vanogamuchira neoadjuvant therapy vakagamuchira 4 mitsetse yeFOLFIRINOX yakateverwa nekudzokorora danho uye kuvhiyiwa, ichiteverwa ne8 mitsetse ye adjuvant mFOLFIRINOX.Mhedzisiro yekutanga yaive yekurarama kwese (OS), uye chidzidzo chakapihwa simba kuratidza kuvandudzwa kwekupona kwemwedzi gumi nemisere kubva pa50% nekuvhiyiwa kumberi kusvika 70% ine neoadjuvant FOLFIRINOX.
Dhiyabhorosi yaisanganisira varwere vane 140 vane chirwere cheECOG 0 kana 1. Muboka rekutanga rekuvhiya, 56 yevarwere ve63 (89%) vakavhiyiwa uye 47 (75%) vakatanga adjuvant chemotherapy.Pavarwere makumi manomwe nevanomwe vakapihwa neoadjuvant therapy, 64 (83%) vakatanga kurapa, 40 (52%) vakapedza kurapwa, 63 (82%) vakaitwa resection, uye 51 (66%) vakatanga adjuvant therapy.
Giredhi ≥3 zviitiko zvakashata (AEs) zvakaonekwa mu55.6% yevarwere vanogamuchira neoadjuvant chemotherapy, kunyanya manyoka, kuda kurutsa uye kurutsa, uye neutropenia.Munguva yeadjuvant chemotherapy, inenge 40% yevarwere muboka rega rega rekurapa vakawana giredhi ≥3 AEs.
Mukuongorora kwechinangwa chekurapa, kupona kwepakati neadjuvant therapy yaive mwedzi 25.1 zvichienzaniswa nemwedzi makumi matatu nemasere nekuvhiyiwa kumberi, uye neoadjuvant chemotherapy yakawedzera njodzi yekupona ne52% (95% CI 0.94-2.46, P = 0.06).Mwero wegumi nemisere wekupona waive makumi matanhatu muzana neoadjuvant FOLFIRINOX uye 73% nekuvhiyiwa kumberi.Per-protocol assays yakaburitsa zvakafanana.
Histopathological results inofarira neoadjuvant chemotherapy sezvo 56% yevarwere vakawana R0 mamiriro kana ichienzaniswa ne39% yevarwere vakavhiyiwa mberi (P = 0.076) uye 29% vakawana N0 mamiriro kana 14% yevarwere (P = 0.060).Per-protocol analysis yakaratidza zvakasiyana-siyana zvakasiyana neoadjuvant FOLFIRINOX muR0 mamiriro (59% vs. 33%, P = 0.011) uye N0 mamiriro (37% vs. 10%, P = 0.002).
Charles Bankhead mukuru weoncology mupepeti uye zvakare anovhara urology, dermatology uye ophthalmology.Akabatana neMedPage Nhasi mu2007.
Chidzidzo ichi chakatsigirwa neNorwegian Cancer Society, Regional Health Authority yeSouth-East Norway, Swedish Sjoberg Foundation uye Helsinki University Hospital.
Ko 披露了与 Clinical Care Options、Gerson Lehrman Group、Medscape、MJH Life Sciences、Research to Practice、AADi、FibroGen、Genentech、GRAIL、Ipsen、Merus、Roche、AbGenomics、Apexigen、Astellas、BioMed Valley Discoveries .Celgene, CrystalGenomics, Leap Therapeutics nemamwe makambani.
Kwakabva Citation: Labori KJ et al."Short-course neoadjuvant FOLFIRINOX inopesana nekuvhiyiwa kwepamberi kwekenza yepancreatic inogadziriswa: a multicenter randomized phase II trial (NORPACT-1)," ASCO 2023;Abstract LBA4005.
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Nguva yekutumira: Sep-22-2023