MaltSci 麦伴科研

Appearance

文献精选 > 近年高分"CRISPR基因编辑"研究（IF≥30，近5年）

Advances in the treatment of intrahepatic cholangiocarcinoma: An overview of the current and future therapeutic landscape for clinicians. ​

文献信息 ​

DOI10.3322/caac.21759
PMID36260350
期刊CA: a cancer journal for clinicians
影响因子232.4
JCR 分区Q1
发表年份2023
被引次数225
关键词化疗、免疫疗法、肝内胆管癌、局部区域治疗
文献类型Journal Article, Review
ISSN0007-9235
页码198-222
期号73(2)
作者Dimitrios Moris, Manisha Palta, Charles Kim, Peter J Allen, Michael A Morse, Michael E Lidsky

一句话小结 ​

本研究综述了肝内胆管癌（ICC）的治疗现状与未来策略，指出尽管切除手术是唯一可能治愈的方式，但大多数患者不可切除，生存期仅约1年。近年来，吉西他滨和顺铂的二联化疗、三联方案、免疫治疗以及新兴的分子靶向治疗为患者提供了更好的生存机会，推动了个性化和多学科治疗方案的制定。

在麦伴科研 (maltsci.com) 搜索更多文献 ​

化疗 · 免疫疗法 · 肝内胆管癌 · 局部区域治疗

摘要 ​

肝内胆管癌（ICC）是第二常见的原发性肝肿瘤，在大多数患者中仍然是一种致命的恶性肿瘤。大约20%-30%的患者有资格接受切除手术，而切除被认为是唯一可能治愈的治疗方法；在切除后，当与辅助卡培他滨联合使用时，已报告中位生存期为53个月。对于70%-80%表现为局部不可切除或远处转移疾病的患者，系统治疗可能会延缓病情进展，但生存期仍然仅限于约1年。在过去十年中，吉西他滨和顺铂的二联化疗被认为是最有效的一线治疗方案，但近年来三联方案甚至免疫治疗的结果可能会改变这一格局。还开发了更有效的治疗策略，包括将系统治疗与局部区域治疗（如放射栓塞或肝动脉灌注）相结合的方案。分子治疗，包括针对成纤维细胞生长因子受体和异柠檬酸脱氢酶的治疗，最近已获得美国食品和药物管理局的批准，作为第二线治疗在高达40%携带这些可操作基因改变的患者中发挥特定作用，是否应在一线治疗中考虑仍在研究中。此外，随着肿瘤学领域寻求扩大免疫治疗的适应症，最近的数据表明，将durvalumab与标准细胞毒疗法结合使用改善了ICC患者的生存率。本综述集中于ICC治疗的当前和未来策略，包括对每种治疗方式的主要文献总结，以及可用于推动对这种具有挑战性恶性肿瘤患者进行个性化和多学科方法的算法。

英文摘要 ​

Intrahepatic cholangiocarcinoma (ICC) is the second most common primary liver tumor and remains a fatal malignancy in the majority of patients. Approximately 20%-30% of patients are eligible for resection, which is considered the only potentially curative treatment; and, after resection, a median survival of 53 months has been reported when sequenced with adjuvant capecitabine. For the 70%-80% of patients who present with locally unresectable or distant metastatic disease, systemic therapy may delay progression, but survival remains limited to approximately 1 year. For the past decade, doublet chemotherapy with gemcitabine and cisplatin has been considered the most effective first-line regimen, but results from the recent use of triplet regimens and even immunotherapy may shift the paradigm. More effective treatment strategies, including those that combine systemic therapy with locoregional therapies like radioembolization or hepatic artery infusion, have also been developed. Molecular therapies, including those that target fibroblast growth factor receptor and isocitrate dehydrogenase, have recently received US Food and Drug Administration approval for a defined role as second-line treatment for up to 40% of patients harboring these actionable genomic alterations, and whether they should be considered in the first-line setting is under investigation. Furthermore, as the oncology field seeks to expand indications for immunotherapy, recent data demonstrated that combining durvalumab with standard cytotoxic therapy improved survival in patients with ICC. This review focuses on the current and future strategies for ICC treatment, including a summary of the primary literature for each treatment modality and an algorithm that can be used to drive a personalized and multidisciplinary approach for patients with this challenging malignancy.

麦伴智能科研服务 ​

智能阅读回答你对文献的任何问题，帮助理解文献中的复杂图表和公式
定位观点定位某个观点在文献中的蛛丝马迹
加入知识库完成数据提取，报告撰写等更多高级知识挖掘功能

主要研究问题 ​

  1. 在当前治疗策略中，如何评估和选择适合患者的个体化治疗方案？
  2. 针对不适合手术的患者，除了化疗，还有哪些新兴的局部治疗方法可以考虑？
  3. 免疫疗法在肝内胆管癌的治疗中有哪些具体的临床试验结果和潜在应用？
  4. 分子靶向治疗的最新进展如何影响肝内胆管癌患者的预后和治疗选择？
  5. 在不同的基因突变背景下，如何优化化疗和靶向治疗的联合使用策略？

核心洞察 ​

1. 研究背景和目的 ​

肝内胆管癌（ICC）是第二常见的原发性肝肿瘤，病程通常较为凶险，大多数患者面临致命的结局。尽管约20%-30%的患者可以通过手术切除获得治愈机会，但大多数患者在确诊时已为局部不可切除或转移性疾病，导致有效生存期受到限制。因此，本研究旨在概述当前及未来的治疗策略，以帮助临床医生更好地应对这一挑战性疾病。

2. 主要方法和发现 ​

研究总结了不同治疗模式的现状和未来发展方向，包括：

  • 手术切除：被视为唯一的潜在治愈方法，合并辅助化疗可提高生存率。
  • 系统治疗：对于70%-80%的不可切除或转移患者，传统的双药化疗方案（吉西他滨和顺铂）是首选，但新的三药联合方案和免疫治疗正在探索中，可能改变治疗格局。
  • 局部治疗结合系统治疗：如放射栓塞或肝动脉灌注等新策略的开发，显示出联合治疗的潜力。
  • 分子靶向治疗：针对成纤维生长因子受体和异柠檬酸脱氢酶的分子治疗已经获得FDA批准，适用于约40%的患者，未来有可能被考虑用于一线治疗。
  • 免疫治疗的结合应用：最近研究显示，联合使用durvalumab与传统化疗可改善ICC患者的生存率。

3. 核心结论 ​

ICC的治疗正朝着更加个体化和多学科的方向发展。尽管手术仍然是治愈的主要途径，但对于无法切除的患者，新的化疗方案、局部治疗及分子靶向治疗显示出良好的前景。未来的研究将进一步探索免疫治疗与其他疗法的结合方式，以期提高患者的生存率和生活质量。

4. 研究意义和影响 ​

本综述不仅为临床医生提供了ICC治疗的现状与前景，还强调了个体化治疗及多学科合作的重要性。这一研究的意义在于推动ICC治疗的临床实践，促进新疗法的应用，最终改善患者的预后和生存质量。通过整合当前的研究成果和治疗策略，医生可以更好地为患者制定有效的治疗计划，从而在这一挑战性疾病的斗争中取得进展。

引用本文的文献 ​

  1. The Application of Artificial Intelligence to Investigate Long-Term Outcomes and Assess Optimal Margin Width in Hepatectomy for Intrahepatic Cholangiocarcinoma. - Laura Alaimo;Zorays Moazzam;Yutaka Endo;Henrique A Lima;Swatika P Butey;Andrea Ruzzenente;Alfredo Guglielmi;Luca Aldrighetti;Matthew Weiss;Todd W Bauer;Sorin Alexandrescu;George A Poultsides;Shishir K Maithel;Hugo P Marques;Guillaume Martel;Carlo Pulitano;Feng Shen;François Cauchy;Bas Groot Koerkamp;Itaru Endo;Minoru Kitago;Alex Kim;Aslam Ejaz;Joal Beane;Jordan Cloyd;Timothy M Pawlik - Annals of surgical oncology (2023)
  2. Intrahepatic Cholangiocarcinoma-Where Are We Now and Where Are We Going to? - Michał P Wasilewicz;Rafał Becht - Medicina (Kaunas, Lithuania) (2023)
  3. MMP14 is a diagnostic gene of intrahepatic cholangiocarcinoma associated with immune cell infiltration. - Jun Wu;Yang Guo;Zhi-Fan Zuo;Zi-Wei Zhu;Lei Han - World journal of gastroenterology (2023)
  4. Identification and validation of a plasma metabolomics-based model for risk stratification of intrahepatic cholangiocarcinoma. - Jiehui Tan;Man Shu;Junbin Liao;Ruiming Liang;Shiyi Liu;Ming Kuang;Sui Peng;Han Xiao;Qian Zhou - Journal of cancer research and clinical oncology (2023)
  5. An age-group analysis on the efficacy of chemotherapy in older adult patients with metastatic biliary tract cancer: a Japanese cancer registry cohort study. - Takeru Hirao;Kenji Ikezawa;Toshitaka Morishima;Kazuma Daiku;Yusuke Seiki;Ko Watsuji;Yasuharu Kawamoto;Sena Higashi;Makiko Urabe;Yugo Kai;Ryoji Takada;Takuo Yamai;Kaori Mukai;Tasuku Nakabori;Hiroyuki Uehara;Isao Miyashiro;Kazuyoshi Ohkawa - BMC gastroenterology (2023)
  6. Letter to the Editor: Comment on "Comparing Survival After Resection, Ablation, and Radiation in Small Intrahepatic Cholangiocarcinoma". - Min Wu;Zhichao Chen;Yonghua Lin;Jianfeng Wei - Annals of surgical oncology (2023)
  7. Proposal for a new N-stage classification system for intrahepatic cholangiocarcinoma. - Shan Liao;Ruizhe Liao;Huaxing Wu;Shijie Wang;Yanming Zhou - Frontiers in oncology (2023)
  8. Case Report: Camrelizumab combined with gemcitabine and oxaliplatin in the treatment of advanced intrahepatic cholangiocarcinoma: a case report and literature review. - Zhongyan Zhang;Xin Wang;Hehe Li;Huimin Sun;Jianhong Chen;Hongfeng Lin - Frontiers in immunology (2023)
  9. Tumor size and survival in intrahepatic cholangiocarcinoma treated with surgical resection or ablation. - Elishama N Kanu;Kristen E Rhodin;Sabran J Masoud;Austin M Eckhoff;Alex J Bartholomew;Thomas C Howell;Jiayin Bao;Nicholas T Befera;Charles Y Kim;Dan G Blazer;Sabino Zani;Daniel P Nussbaum;Peter J Allen;Michael E Lidsky - Journal of surgical oncology (2023)
  10. Anatomic versus non-anatomic resection for early-stage intrahepatic cholangiocarcinoma: a propensity score matching and stabilized inverse probability of treatment weighting analysis. - Qiao Ke;Lei Wang;Ziguo Lin;Hongzhi Liu;Jianying Lou;Shuguo Zheng;Xinyu Bi;Jianming Wang;Wei Guo;Fuyu Li;Jian Wang;Yamin Zheng;Jingdong Li;Shi Cheng;Weiping Zhou;Jingfeng Liu;Yongyi Zeng - BMC cancer (2023)

... (215 更多 篇文献)

© 2025 MaltSci 麦伴科研 - 我们用人工智能技术重塑科研