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Multi-institutional retrospective analysis of FOLFIRI in patients with advanced biliary tract cancers

World Journal of Gastrointestinal Oncology 2020年第1期12卷 83-91页

作者： Jonathan D Mizrahi Valerie Gunchick kabir mody Lianchun Xiao Phanikeerthi Surapaneni Rachna T Shroff Vaibhav Sahai Division of Cancer Medicine The University of Texas MD Anderson Cancer CenterHoustonTX 77005United States Department of Internal Medicine University of MichiganAnn ArborMI 48109United States Division of Medical Oncology Mayo Clinic Cancer CenterJacksonvilleFL 32224United States University of Arizona Cancer Center University of ArizonaTucsonAZ 85724United States

BACKGROUND Gemcitabine plus platinum is the standard of care first-line treatment for advanced biliary tract cancers(BTC).There is no established second-line therapy,and retrospective reviews report median progression-free survival(PFS)less than 3 mo on second-line therapy.5-Fluorouracil plus irinotecan(FOLFIRI)is a commonly used regimen in patients with BTC who have progressed on gemcitabine plus platinum,though there is a paucity of data regarding its efficacy in this *** To assess the efficacy of FOLFIRI in patients with biliary tract *** We retrospectively identified patients with advanced BTC who were treated with FOLFIRI at MD Anderson,University of Michigan and Mayo Clinic in *** were collected on patient demographics,BTC subtype,response per RECIST v1.1,progression and *** Ninety-eight patients were included of which 74(75%)had metastatic and 24(25%)had locally advanced disease at the time of treatment with *** median age was 60(range,22-86)*** number of patients with extrahepatic cholangiocarcinoma,gall bladder cancer and intrahepatic cholangiocarcinoma were 10,17 and 71,*** was used as 1st,2nd,3rd or 4th–Nth lines in 8,50,36 and 4 patients,*** duration on FOLFIRI in the entire cohort was 2.2(range,0.5-8.4)*** median PFS and overall survival were 2.4(95%confidence interval(CI):1.7-3.1)and 6.6(95%CI:4.7-8.4)mo,*** PFS for patients treated with FOLFIRI in 1st,2nd,3rd or 4th–Nth lines were 3.1,2.5,2.3 and 1.5 mo,*** patients received concurrent bevacizumab(n=13)or EGFR-targeted therapy(n=5)with FOLFIRI,with a median PFS of 2.7 mo(95%CI:1.7-5.1).CONCLUSION In this largest multi-institution retrospective review of 98 patients with BTC treated with FOLFIRI,efficacy appears to be modest with outcomes similar to other cytotoxic chemotherapy regimens.

关键词： Biliary tract neoplasms Fluorouracil Irinotecan Cholangiocarcinoma Retrospective studies

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Drug eluting biliary stents to decrease stent failure rates:Areview of the literature

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World Journal of Gastrointestinal Endoscopy 2016年第2期8卷 77-85页

作者： Joseph Shatzel Jisoo Kim Kartik Sampath Sharjeel Syed Jennifer Saad Zilla H Hussain kabir mody J Marc Pipas Stuart Gordon Timothy Gardner Richard I Rothstein Section of Hematology-Oncology Dartmouth Hitchcock Medical CenterLebanonNH 03756United States Geisel School of Medicine at Dartmouth HanoverNH 03755United States Section of Gastroenterology Dartmouth Hitchcock Medical CenterLebanonNH 03756United States Section of Internal Medicine Dartmouth Hitchcock Medical CenterLebanonNH 03756United States Mayo Clinic Cancer Center Section of Hematology/OncologyMayo Clinic FloridaJacksonvilleFL 32224United States

Biliary stenting is clinically effective in relieving both malignant and non-malignant obstructions. However, there are high failure rates associated with tumor ingrowth and epithelial overgrowth as well as internally from biofilm development and subsequent clogging. Within the last decade, the use of prophylactic drug eluting stents as a means to reduce stent failure has been investigated. In this review we provide an overview of the current research on drug eluting biliary stents. While there is limited human trial data regarding the clinical benefit of drug eluting biliary stents in preventing stent obstruction, recent research suggests promise regarding their safety and potential efficacy.

关键词： Bile ducts Cholangiocarcinoma Endoscopy Pancreas

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