ʻO ka chemotherapy neoadjuvant a me ka ʻoki ʻana i mua no ka maʻi maʻi pancreatic reectable

CHICAGO—ʻAʻole hiki ke hoʻohālikelike i ka chemotherapy neoadjuvant no ke ola ʻana no ka maʻi maʻi pancreatic reectable, kahi hōʻike hoʻokolohua liʻiliʻi liʻiliʻi.
ʻO ka mea i manaʻo ʻole ʻia, ʻoi aku ka lōʻihi o ka noho ʻana o ka poʻe maʻi i hōʻoki ʻia no ka manawa mua ma mua o hoʻokahi makahiki ma mua o ka poʻe i loaʻa i kahi papa pōkole o FOLFIRINOX chemotherapy ma mua o ka hana ʻana.ʻO kēia hopena he mea kahaha loa no ka pili ʻana o ka neoadjuvant therapy me ka helu kiʻekiʻe o nā palena ʻoki kino maikaʻi ʻole (R0) a ʻoi aku ka nui o nā maʻi i ka hui lapaʻau i loaʻa i ke kūlana node-negative.
"E wehewehe maikaʻi paha ka hahai ʻana i ka hopena lōʻihi o ka hoʻomaikaʻi ʻana i ka R0 a me N0 i ka hui neoadjuvant," wahi a Knut Jorgen Laborie, MD, University of Oslo, Norway, American Society of Clinical Oncology.ASCO) halawai."ʻAʻole kākoʻo nā hopena i ka hoʻohana ʻana i ka neoadjuvant FOLFIRINOX ma ke ʻano he lapaʻau maʻamau no ka maʻi maʻi pancreatic resectable."
Ua hoʻopūʻiwa kēia hopena iā Andrew H. Ko, MD, o ke Kulanui o Kaleponi, Kapalakiko, i kono ʻia i ke kūkākūkā, a ua ʻae ʻo ia ʻaʻole lākou e kākoʻo i ka neoadjuvant FOLFIRINOX ma ke ʻano he ʻokoʻa i ke ʻoki mua.Akā ʻaʻole lākou e kāpae i kēia hiki.Ma muli o kekahi hoihoi i ke aʻo ʻana, ʻaʻole hiki ke hana i kahi ʻōlelo kikoʻī e pili ana i ke kūlana e hiki mai ana o FOLFIRINOX neoadjuvant.
Ua ʻike ʻo Ko, ʻo ka hapalua wale nō o nā maʻi i hoʻopau i ʻehā mau pōʻai o ka neoadjuvant chemotherapy, "ʻoi aku ka haʻahaʻa ma mua o ka mea aʻu i manaʻo ai no kēia pūʻulu o nā maʻi, ʻaʻole paʻakikī loa nā ʻehā o ka mālama ʻana... ʻO ka lua, no ke aha i ʻoi aku ka maikaʻi o nā hopena ʻoki a me nā pathologic [R0, N0 kūlana] alakaʻi i kahi ʻano i nā hopena ʻino i ka hui neoadjuvant?e hoʻomaopopo i ke kumu a hoʻololi i nā regimen e pili ana i ka gemcitabine.
"No laila, ʻaʻole hiki iā mākou ke huki i nā manaʻo paʻa mai kēia noiʻi ʻana e pili ana i ka hopena kūikawā o FOLFIRINOX perioperative i nā hopena ola… Loaʻa ʻia ka FOLFIRINOX, a ke manaʻo nei kekahi mau haʻawina e hoʻomau nei e hoʻomālamalama i kona hiki ke hana hou ʻia."Nā maʻi.”
Ua ʻike ʻo Laborie, ʻo ka hana ʻana i hui pū ʻia me ka ʻōnaehana systemic e hāʻawi i nā hopena maikaʻi loa no ka maʻi maʻi pancreatic reectable.ʻO ka mea maʻamau, ua hoʻokomo ʻia ka maʻamau o ka mālama ʻana i ka ʻoki mua a me ka chemotherapy adjuvant.Eia nō naʻe, ua hoʻomaka ka neoadjuvant therapy i ukali ʻia e ka ʻoki a me ka adjuvant chemotherapy i kaulana i waena o nā poʻe oncologists.
Hāʻawi ʻo Neoadjuvant therapy i nā pōmaikaʻi he nui: ka hoʻomalu mua ʻana i ka maʻi ʻōnaehana, hoʻomaikaʻi i ka lawe ʻana i ka chemotherapy, a hoʻomaikaʻi i nā hopena histopathological (R0, N0), hoʻomau ʻo Laborie.Eia nō naʻe, i kēia lā, ʻaʻohe hoʻāʻo randomized i hōʻike maopopo i kahi pōmaikaʻi ola o ka chemotherapy neoadjuvant.
No ka hoʻoponopono ʻana i ka nele o ka ʻikepili i nā hoʻokolohua randomized, ua ʻimi nā mea noiʻi mai nā kikowaena 12 ma Norewai, Suède, Denmark a me Finland i nā maʻi me ka maʻi maʻi maʻi pancreatic.Ua loaʻa i nā poʻe maʻi i hoʻokaʻawale ʻia i ka ʻoki ʻana i mua he 12 mau pōʻai o FOLFIRINOX (mFOLFIRINOX) i hoʻololi ʻia adjuvant.Ua loaʻa i nā poʻe maʻi e loaʻa ana i ka lāʻau neoadjuvant he 4 pōʻaiapuni o FOLFIRINOX a ukali ʻia e ka hana hou ʻana a me ke ʻoki ʻana, a ukali ʻia e 8 mau pōʻai o ka adjuvant mFOLFIRINOX.ʻO ka hopena mua ke ola holoʻokoʻa (OS), a ua hoʻoikaika ʻia ke aʻo ʻana e hōʻike i ka hoʻomaikaʻi ʻana i ke ola 18 mau mahina mai 50% me ka ʻoki ʻana i mua a hiki i 70% me ka neoadjuvant FOLFIRINOX.
Loaʻa ka ʻikepili i nā maʻi maʻi randomized 140 me ke kūlana ECOG 0 a i ʻole 1. I ka hui ʻokiʻoki mua, 56 o 63 mau maʻi (89%) i hana ʻia a me 47 (75%) i hoʻomaka i ka adjuvant chemotherapy.ʻO nā maʻi 77 i hāʻawi ʻia i ka neoadjuvant therapy, 64 (83%) i hoʻomaka i ka lāʻau lapaʻau, 40 (52%) i hoʻopau i ka lāʻau lapaʻau, 63 (82%) i hoʻopaʻa ʻia, a me 51 (66%) hoʻomaka i ka adjuvant therapy.
Ua ʻike ʻia ka papa ≥3 i nā hanana ʻino (AEs) i 55.6% o nā maʻi e loaʻa ana i ka chemotherapy neoadjuvant, ka nui o ka maʻi maʻi, nausea a me ka luaʻi, a me ka neutropenia.I ka wā o ka chemotherapy adjuvant, ma kahi o 40% o nā maʻi i kēlā me kēia hui lapaʻau i ʻike i ka pae ≥3 AE.
I loko o ka nānā ʻana i ka manaʻo-e-treat, ʻo ke ola holoʻokoʻa me ka neoadjuvant therapy he 25.1 mau mahina i hoʻohālikelike ʻia me 38.5 mau mahina me ka ʻoki ʻana i mua, a hoʻonui ka neoadjuvant chemotherapy i ka pilikia o ke ola ʻana e 52% (95% CI 0.94-2.46, P=0.06).ʻO ka helu ola 18 mau mahina he 60% me ka neoadjuvant FOLFIRINOX a me 73% me ka ʻoki ʻana i mua.Ua loaʻa nā hopena like i nā hoʻokolohua per-protocol.
ʻO nā hopena histopathologic e makemake i ka chemotherapy neoadjuvant e like me ka 56% o nā maʻi i loaʻa i ke kūlana R0 i hoʻohālikelike ʻia me 39% o nā mea maʻi i mua o ke kaʻina (P = 0.076) a me 29% i loaʻa ke kūlana N0 i hoʻohālikelike ʻia me 14% o nā maʻi (P = 0.060).Ua hōʻike ʻia nā ʻokoʻa koʻikoʻi o kēlā me kēia protocol me ka neoadjuvant FOLFIRINOX i ke kūlana R0 (59% vs. 33%, P=0.011) a me ke kūlana N0 (37% vs. 10%, P=0.002).
ʻO Charles Bankhead he luna hoʻoponopono oncology kiʻekiʻe a uhi pū kekahi i ka urology, dermatology a me ka ophthalmology.Ua komo ʻo ia me MedPage Today ma 2007.
Ua kākoʻo ʻia ke aʻo ʻana e ka Norwegian Cancer Society, ka Regional Health Authority o South-East Norway, ka Swedish Sjoberg Foundation a me Helsinki University Hospital.
Ko 披露了与 Nā koho mālama maʻi, Gerson Lehrman Group, Medscape, MJH Life Sciences, Research to Practice, AAdi, FibroGen, Genentech, GRAIL, Ipsen, Merus, Roxiomics, Discovery Valley, AbGenomics. “Bristol Myers Squibb” .Celgene, CrystalGenomics, Leap Therapeutics a me nā hui ʻē aʻe.
Kuhikuhi Kumu: Labori KJ et al."ʻO FOLFIRINOX neoadjuvant pōkole pōkole e kū'ē i ke kaʻina mua no ka maʻi maʻi poʻo pancreatic hiki ke hoʻihoʻi ʻia: kahi hoʻokolohua multicenter randomized phase II (NORPACT-1)," ASCO 2023;LBA4005 kiko'ī.
ʻO nā mea ma kēia pūnaewele no ka ʻike ʻike wale nō a ʻaʻole i manaʻo ʻia e pani i ka ʻōlelo aʻoaʻo lapaʻau, ka maʻi maʻi, a i ʻole ka mālama ʻana mai kahi mea mālama olakino kūpono.© 2005-2023 MedPage Today, LLC, he hui ʻo Ziff Davis.Ua mālama ʻia nā kuleana āpau.ʻO Medpage Today kahi hōʻailona hoʻopaʻa inoa federally o MedPage Today, LLC a ʻaʻole hiki ke hoʻohana ʻia e nā ʻaoʻao ʻekolu me ka ʻole o ka ʻae ʻia.