Neoadjuvant chemotherapy na ịwa ahụ n'ihu maka ọrịa cancer pancreatic resectable

CHICAGO-Neoadjuvant chemotherapy enweghị ike dakọtara ịwa ahụ n'ihu maka nlanarị maka ọrịa kansa pancreatic nwere ike ịghagharị, obere nnwale na-egosi.
N'ụzọ a na-atụghị anya ya, ndị ọrịa a wara ahụ na nke mbụ biri ndụ ihe karịrị otu afọ karịa ndị natara obere usoro nke FOLFIRINOX chemotherapy tupu ịwa ahụ.Nsonaazụ a bụ ihe ịtụnanya karịsịa n'ihi na ejikọtara ọgwụgwọ neoadjuvant na ọnụ ọgụgụ dị elu nke oke ịwa ahụ na-adịghị mma (R0) yana na ọtụtụ ndị ọrịa nọ na otu ọgwụgwọ ahụ nwetara ọnọdụ adịghị mma.
"Nsochi ọzọ nwere ike ịkọwa mmetụta dị ogologo oge nke mmezi na R0 na N0 na otu neoadjuvant," Knut Jorgen Laborie, MD, Mahadum Oslo, Norway, American Society of Clinical Oncology kwuru.ASCO) nzukọ."Nsonaazụ akwadoghị iji neoadjuvant FOLFIRINOX dị ka ọgwụgwọ ọkọlọtọ maka ọrịa cancer pancreatic resectable."
Nsonaazụ a tụrụ Andrew H. Ko, MD, nke Mahadum California, San Francisco n'anya, bụ onye a kpọrọ òkù na mkparịta ụka ahụ, ma kweta na ha anaghị akwado neoadjuvant FOLFIRINOX dị ka ihe ọzọ maka ịwa ahụ n'ihu.Mana ha anaghị ewepu ohere a.N'ihi mmasị ụfọdụ na ọmụmụ ihe ahụ, ọ gaghị ekwe omume ịme nkwupụta doro anya gbasara ọnọdụ FOLFIRINOX neoadjuvant n'ọdịnihu.
Ko kwuru na ọ bụ nanị ọkara nke ndị ọrịa ahụ mezuru usoro anọ nke neoadjuvant chemotherapy, “nke dị nnọọ ala karịa ihe m tụrụ anya ya maka ìgwè ndị ọrịa a, bụ́ ndị usoro ọgwụgwọ anọ na-adịkarịghị esiri ike…...Nke abuo, kedu ihe kpatara nsonaazụ ịwa ahụ na ọrịa pathologic ka mma [R0, N0 status] na-eduga n'omume na-ebute nsonaazụ ka njọ na otu neoadjuvant?ghọta ihe kpatara ya wee gbanwee gaa na usoro gemcitabine."
"Ya mere, anyị enweghị ike nweta nkwubi okwu siri ike site na ọmụmụ ihe a gbasara mmetụta FOLFIRINOX na-arụ ọrụ na nsonazụ ndụ… FOLFIRINOX ka dị, na ọtụtụ ọmụmụ na-aga n'ihu ga-atụ anya na-amụbawanye ike ya na ịwa ahụ."Ọrịa.”
Laborie kwuru na ịwa ahụ jikọtara ya na usoro ọgwụgwọ dị irè na-enye nsonaazụ kacha mma maka ọrịa cancer pancreatic nwere ike ịghaghachi.Na omenala, ụkpụrụ nlekọta gụnyere ịwa ahụ n'ihu na ọgwụgwọ adjuvant.Otú ọ dị, ọgwụgwọ neoadjuvant na-esote ịwa ahụ na adjuvant chemotherapy amalitela inweta ewu ewu n'etiti ọtụtụ ndị ọkà mmụta oncologists.
Usoro ọgwụgwọ Neoadjuvant na-enye ọtụtụ uru ndị nwere ike inweta: njikwa mmalite nke ọrịa sistemu, nnyefe nke chemotherapy ka mma, yana nsonaazụ akụkọ ihe mere eme (R0, N0), Laborie gara n'ihu.Otú ọ dị, ruo taa, ọ dịghị ule na-enweghị usoro egosila n'ụzọ doro anya uru nlanarị nke neoadjuvant chemotherapy.
Iji dozie enweghị data na ule ndị a na-atụghị anya ya, ndị nchọpụta sitere na ụlọ ọrụ 12 dị na Norway, Sweden, Denmark na Finland wetara ndị ọrịa nwere ọrịa cancer isi nke pancreatic resectable.Ndị ọrịa gbadoro anya na ịwa ahụ n'ihu natara usoro 12 nke adjuvant-modified FOLFIRINOX (mFOLFIRINOX).Ndị ọrịa na-anata ọgwụgwọ neoadjuvant natara cycles 4 nke FOLFIRINOX sochiri usoro nhazi na ịwa ahụ, usoro 8 nke adjuvant mFOLFIRINOX sochiri ya.Isi njedebe bụ nlanarị n'ozuzu (OS), na ọmụmụ ihe a kwadoro ka ọ gosipụta ọganihu na ndụ ọnwa 18 site na 50% na ịwa ahụ n'ihu ruo 70% na neoadjuvant FOLFIRINOX.
Data gụnyere 140 randomized ndị ọrịa nwere ọnọdụ ECOG 0 ma ọ bụ 1. N'ime otu ịwa ahụ mbụ, 56 nke ndị ọrịa 63 (89%) mere ịwa ahụ na 47 (75%) malitere adjuvant chemotherapy.N'ime ndị ọrịa 77 e kenyere ọgwụgwọ neoadjuvant, 64 (83%) malitere ọgwụgwọ, 40 (52%) mezuru usoro ọgwụgwọ, 63 (82%) na-enweta ọgwụgwọ, na 51 (66%) malitere ọgwụgwọ adjuvant.
Ahụrụ ọkwa ≥3 ihe ọjọọ (AEs) na 55.6% nke ndị ọrịa na-anata chemotherapy neoadjuvant, ọkachasị afọ ọsịsa, ọgbụgbọ na vomiting, na neutropenia.N'oge adjuvant chemotherapy, ihe dịka 40% nke ndị ọrịa nọ na otu ọgwụgwọ ọ bụla nwetara ọkwa ≥3 AEs.
N'ime nyocha nke ebumnuche-ịgwọta, ogologo ndụ nke etiti na ọgwụgwọ neoadjuvant bụ ọnwa 25.1 ma e jiri ya tụnyere ọnwa 38.5 na ịwa ahụ n'ihu, na chemotherapy neoadjuvant mụbara ohere ịlanarị site na 52% (95% CI 0.94-2.46, P=0.06).Ọnụego nlanarị nke ọnwa 18 bụ 60% yana neoadjuvant FOLFIRINOX yana 73% nwere ịwa ahụ n'ihu.Nnwale kwa-protocol rụpụtara rịzọlt ahụ.
Nsonaazụ Histopathologic na-akwado neoadjuvant chemotherapy dị ka 56% nke ndị ọrịa nwetara ọkwa R0 ma e jiri ya tụnyere 39% nke ndị ọrịa n'ihu ịwa ahụ (P = 0.076) na 29% nwetara ọkwa N0 ma e jiri ya tụnyere 14% nke ndị ọrịa (P = 0.060).Nyocha nke otu-protocol gosipụtara ọdịiche dị ịrịba ama na neoadjuvant FOLFIRINOX na ọkwa R0 (59% vs. 33%, P=0.011) na ọkwa N0 (37% vs. 10%, P=0.002).
Charles Bankhead bụ onye nchịkọta akụkọ oncology dị elu ma na-ekpuchikwa urology, dermatology na ophthalmology.Ọ sonyeere MedPage Taa na 2007.
Ndị Norwegian Cancer Society, Regional Health Authority nke South-East Norway, Swedish Sjoberg Foundation na Ụlọ Ọgwụ Mahadum Helsinki kwadoro ọmụmụ ihe ahụ.
Ko 披露了与 Clinical Care Options, Gerson Lehrman Group, Medscape, MJH Life Sciences, Research to Practice,AADi, FibroGen, Genentech, GRAIL, Ipsen, Merus, Roxiics, Roxiics OMed Valley chọpụtara “Bristol Myers Squibb” .Celgene, CrystalGenomics, Leap Therapeutics na ụlọ ọrụ ndị ọzọ.
Isi mmalite: Labori KJ et al."Obere oge neoadjuvant FOLFIRINOX megide ịwa ahụ n'ihu maka ọrịa cancer isi nke pancreatic resectable: a multicenter randomized phase II trial (NORPACT-1)," ASCO 2023;Ọnụ ego LBA4005.
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