晚期胰腺导管腺癌药物治疗进展

由于特殊的免疫抑制微环境以及缺少可作为药物靶点的驱动基因突变, 胰腺导管腺癌(pancreatic ductal adenocarcinoma, PDAC)患者的预后较其他恶性肿瘤患者差。目前化疗仍是多数晚期PDAC的主要治疗手段。近年来, 随着抗肿瘤药物不断更新及二代测序技术进一步普及, 基因检测可指导部分晚期PDAC患者化疗与分子靶向药物治疗方案的制订。国内外指南均推荐所有晚期PDAC患者接受体系及胚系基因检测, 以确定最佳治疗策略。当前, 针对PDAC主要驱动基因KRAS的分子靶向药物、肿瘤疫苗及抗肿瘤代谢药物等仍处于临床研究阶段。本文将对PDAC药物治疗现状及进展作一综述。

Novel Treatment Strategies for Advanced Pancreatic Ductal Adenocarcinoma

Due to the immunosuppressive microenvironment as well as the lack of medicine that targets the driver gene alterations, the prognosis of patients with pancreatic ductal adenocarcinoma(PDAC)is worse than that of other malignant tumors.At present, chemotherapy is still the main stay of treatment for most patients with advanced PDAC. In recent years, with the continuous development of anti-cancer drugs and the wide application of next-generation sequencing technology, increasing number of studies have shown that genetic alteration could guide the selection of chemotherapy regimen and molecular targeted therapy for some patients with advanced PDAC.Guidelines of the National Comprehensive Cancer Network and Chinese Society of Clinical Oncology recommend that all patients with advanced PDAC should undergo somatic and germline genetic profiling to help determining the optimal treatment strategy and to prolong patients' survival. Therapy targeting KRAS mutation, cancer vaccines and therapy of anti-tumor metabolism are still in clinical research. This article will review current status and progress of medical treatment for advanced PDAC.