胰腺癌 王晰程.pptVIP

铂类10%左右 * * Updates on Pancreatic Cancer Xicheng Wang GI Medical Oncology Peking University Cancer Hospital GEM (n=277) 1000mg/m2 IV Day1, 8, 15 Every four week S-1 (n=280) 40, 50, 60mg* BID Day1-28 Every six week GEM + S-1 (n=277) GEM: 1000mg/m2 IV Day1, 8 S-1: 30, 40, 50mg* BID Day1-14 Every three week R n=834 Randomized Phase III study of gemcitabine plus S-1 (GS) versus S-1 versus gemcitabine (Gem) in unresectable advanced pancreatic cancer : GEST study Primary End Point： Overall Survival Secondary End Point： Progression Free Survival（PFS） Response Rate（RR） GEST study: OS and PFS Control Arm: GEM 8.8 4.1 Superiority： GEM + S-1 (GS) 10.1 5.7 Non-inferiority： S-1 9.7 3.8 OS PFS GEST study: Objective Response Rate GEST study: Safety Profile Conclusions The OS of S-1 is non-inferior to GEM. S-1 is well tolerated with minor GI toxicity. GC significantly increased PFS without prolonging OS and showed high objective response rate. ASCO2011 #4007 FOLFIRINOX versus Gemcitabine for Metastatic Pancreatic Cancer GEM　1,000 mg/m2 IV weekly×7, 1 week rest, 　　　　　　 then weekly×3q4w oxaliplatin 85 mg/m2 day1, irinotecan 180 mg/m2 day1, LV 400 mg/m2 day1 followed by 5-FU 400 mg/m2 bolus day1 and 2,400 mg/m2 46h continuous infusion biweekly R PS0-1 n=342 FOLFIRINOX 11.1mon 6.8mon 6.4mon 3.7mon FOLFIRINOX: Response Rate and Adverse Event Summary GEM S1 GEM+S1 GEM FOLFIRINOX GEM GEM+ nab-PTX PFS (mon) 4.1 3.8 5.7 3.3 6.4 3.7 5.5 OS (mon) 8.8 9.7 10.1 6.8 11.1 6.7 8.5 RR(%) 13 21 29 9 31.6 8 29 GEST French Study MPACT NCCN Guidelines for Pancreatic Cancer 2013 K. Uesaka, A. Fukutomi, N. Kanemoto, M. Konishi, Matsumoto, Y. Kan