胰腺癌的最新化疗方案(英文)

Gemcitabine+erlotinib(Tarceva)1,3

Cycle 1 (8 week cycle)

Days 1, 8, 15, 22, 29, 36 and 43:Gemcitabine 1,000mg/m2IVfollowed bya 1-week rest,plus

All days:Erlotinib 100mg/day or 150mg/day orally,followed by

Subsequent cycles (4 week cycle)

Days 1, 8 and 15:Gemcitabine 1,000mg/m2IV over 30 min.

All days:Erlotinib 100mg/day or 150mg/day orally.

Gemcitabine+cisplatin(Platinol; CDDP)1,4

Days 1 and 15:Gemcitabine 1,000mg/m2IV+cisplatin 50mg/m2IV.

Repeat cycle every 4 weeks.

GEMOX(fixed-dose rate gemcitabine+oxaliplatin [Eloxatin])1,5,6

Day 1:Gemcitabine 1,000mg/m2IV,plus

Day 2:Oxaliplatin 100mg/m2IV.

Repeat cycle every 2 weeks until disease progression.

Gemcitabine+fluoropyrimidine(capecitabine, Xeloda)1,7

Days 1–21:Gemcitabine 1,000mg/m2IV once weekly+capecitabine 1,660mg/m2orally (830mg/m2twice daily).

Repeat cycle every 4 weeks until disease progression.

FOLFIRINOX(oxaliplatin+irinotecan+5-fluorouracil/leucovorin)1,8,9

Day 1:Oxaliplatin 85mg/m2IV+irinotecan 180mg/m2IV+leucovorin 400mg/m2IV,followed bya 5-FU bolus of 400mg/m2and a 46-hr continuous 5-FU infusion of 2,400mg/m2.

Repeat cycle every2 weeks.

Second-Line Therapy

Gemcitabine(in gemcitabine-naïve patients)1,2

Cycle 1 ( 8 week cycle)

Days 1, 8, 15, 22, 29, 36 and 43:Gemcitabine 1,000mg/m2IV administered over 30 min,followed bya 1-week rest.

Subsequent cycles (4 week cycle)

Days 1, 8 and 15:Gemcitabine 1,000mg/m2IV administered over 30 min,followed bya 1-week rest.

Fixed-dose gemcitabine (10mg/m2/min IV) can be substituted for standard infusion of gemcitabine over 30 min.

Capecitabine1,10

Days 1–14:1,000mg/m2orally twice daily.

Repeat cycle every 3 weeks for up to 52 weeks.

5-fluorouracil(5-FU)+leucovorin+oxaliplatin1,11

Days 1, 8, 15 and 22:5-FU 2g/m2IV+leucovorin 200mg/m2IV,plus

Days 8 and 22:Oxaliplatin 85mg/m2IV.

Repeat every 6 weeks.

CapeOx(capecitabine+oxaliplatin)1,12

Age <65yrs and ECOG PS <2

Days 1–14:Oxaliplatin 130mg/m2+capecitabine 1,000mg/m2twice daily.

Repeat cycle every 3 weeks.

Age >65yrs and ECOG PS=2

Days 1–14:Oxaliplatin 110mg/m2+capecitabine 750mg/m2twice daily.

Repeat cycle every 3 weeks.

Locally Advanced Disease

Gemcitabine or gemcitabine-based combination therapy1

May be considered as initial therapy prior to 5-FU-based chemoradiation for patients with locally advanced, unresectable disease.

Adjuvant Therapy

Treatment notes:For patients who relapse after receiving adjuvant therapy, subsequent therapy may consist of gemcitabine or gemcitabine-based combination therapy for patients previously treated with fluoropyrimidine-based therapy, or fluoropyrimidine-based therapy (eg, 5-FU/leucovorin/oxaliplatin or CapeOx) for patients previously treated with gemcitabine-therapy.1, 10, 11

5-FU1,13

Prior to chemoradiation

Days 1–21:5-FU 250mg/m2/day continuous IV infusion; initiate 1–2 weeks prior to chemoradiation (50.4Gy+5-FU 250mg/m2/day).

After chemoradiation

Days 1–28:5-FU 250mg/m2/day continuous IV infusion; initiate 3–5 weeks following chemoradiation.

Repeat cycle every 6 weeks for 3 months.

Gemcitabine1,13

Prior to chemoradiation

Days 1, 8 and 15:Gemcitabine 1,000mg/m2IV; initiate 1–2 weeksprior to chemoradiation (50.4Gy+5-FU 250mg/m2/day).

After chemoradiation

Days 1, 8 and 15:Gemcitabine 1,000mg/m2IV; initiate 3–5 weeksfollowing chemoradiation.

Repeat cycle every 4 weeks for 3 months.

Post-operative gemcitabine1,14

Days 1, 8 and 15:Gemcitabine 1,000mg/m2IV.

Repeat cycle every 4 weeks for 6 months.

Leucovorin+5-FU1,15

Days 1–5:Leucovorin 20mg/m2IV bolus,followed by5-FU 425mg/m2IV bolus.

Repeat cycle every4 weeks.