臨牀消化器内科 Vol.34 No.2(4-2)


特集名 胆囊癌診療の現況
題名 胆囊癌の治療 (2) 化学療法
発刊年月 2019年 02月
著者 黒澤 貴志 杏林大学医学部内科学腫瘍科
著者 岡野 尚弘 杏林大学医学部内科学腫瘍科
著者 長島 文夫 杏林大学医学部内科学腫瘍科
著者 古瀬 純司 杏林大学医学部内科学腫瘍科
【 要旨 】 胆囊癌を含む胆道癌は予後不良な疾患であるが,他の消化器癌に比べて治療開発が遅れていた.切除不能胆道癌に対する治療ではゲムシタビン+シスプラチンが1次治療の標準治療となっている.2次治療ではS-1が多く使用されているがその有用性は明らかではない.術後補助化学療法についても確立した治療法はなく複数の臨床研究が進行中である.近年では分子標的薬や免疫チェックポイント阻害薬の開発やバイオマーカー研究が進み,切除不能進行胆道癌に対して新しい治療開発が進んできている.
Theme The Current Status of Management of Gallbladder Cancer
Title Chemotherapy for Gallbladder Cancer
Author Takashi Kurosawa Department of Medical Oncology, Kyorin University School of Medicine
Author Naohiro Okano Department of Medical Oncology, Kyorin University School of Medicine
Author Fumio Nagashima Department of Medical Oncology, Kyorin University School of Medicine
Author Junji Furuse Department of Medical Oncology, Kyorin University School of Medicine
[ Summary ] Gallbladder cancer is a form of biliary tract cancer (BTC), and prognosis remains extremely poor. Treatments for unresectable or recurrence of BTC are limited, and there are a few chemotherapeutic agents compared to those available for other gastrointestinal cancers. A gemcitabine plus cisplatin regimen has been recognized as the standard chemotherapy for advanced BTC. In Japan, S-1 has also been approved for BTC and is often used for seond-line chemotherapy. Furthermore, S-1 containing regimens have recently been investigated for first-line chemotherapy. Although adjuvant chemotherapy after surgery or the second-line chemotherapy has not been established, some clinical trials in adjuvant or the second-line settings are currently ongoing. Some molecular targeted agents and immune checkpoint inhibitors are also under investigation for BTC. It is expected that new treatment strategies based on biomarkers may be established in the near future.
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