| Theme | Clinical Gastroenterology -- Past 30 Years and Future Vision | |
|---|---|---|
| Title | History and Future of Chemotherapy for Hepatobiliary and Pancreatic Cancer | |
| Publish Date | 2015/01 | |
| Author | Junji Furuse | Department of Medical Oncology, Kyorin University School of Medicine |
| Author | Naohiro Okano | Department of Medical Oncology, Kyorin University School of Medicine |
| Author | Daisuke Naruge | Department of Medical Oncology, Kyorin University School of Medicine |
| Author | Junko Tahara | Department of Medical Oncology, Kyorin University School of Medicine |
| Author | Akiyoshi Kasuga | Department of Medical Oncology, Kyorin University School of Medicine |
| Author | Hiroshi Kitamura | Department of Medical Oncology, Kyorin University School of Medicine |
| Author | Fumio Nagashima | Department of Medical Oncology, Kyorin University School of Medicine |
| [ Summary ] | Advanced hepatobiliary and pancreatic cancers are recognized as difficult diseases to treat, because they are not sensitive to chemotherapy and the prognosis is poor. In late 1990, gemcitabine was established as a standard therapy for unresectable pancreatic cancer. It was also indicated as a post-surgical adjuvant therapy. Furthermore, gemcitabine was used for biliary tract cancer treatment. In a phase III study comparing a combination of gemcitabine and cisplatin (GC therapy) to gemcitabine alone, GC therapy was demonstrated to prolong the survival in patients with unresectable biliary tract cancer. For hepatocellular carcinoma, local treatments, including hepatectomy, radiofrequency ablation, and transcatheter hepatic arterial chemoembolization are used as standard therapies. Chemotherapy has not been used for some time. Since sorafenib has been demonstrated to prolong survival in patients with advanced hepatocellular carcinoma, it has come to be widely used. To treat pancreatic cancer, in addition to gemcitabine alone, gemcitabine plus erlotinib and S-1, FOLFIRINOX are currently used for treating unresectable disease. More effective treatments for first line chemotherapy should be investigated for treatment of these diseases. It is hoped we may establish second line chemotherapy and adjuvant therapy of surgery, especially for hepatobiliary cancer, in the near future. | |