Advanced cholangiocarcinoma is associated with poor prognostic survival and has limited therapeutic options available at present. The importance of angiogenesis and expression of pro-angiogenic factors in intrahepatic...Advanced cholangiocarcinoma is associated with poor prognostic survival and has limited therapeutic options available at present. The importance of angiogenesis and expression of pro-angiogenic factors in intrahepatic forms of cholangiocarcinoma suggest that therapies targeting angiogenesis might be useful for the treatment of this disease. Here we report three cases of patients with advanced intrahepatic cholangiocarcinoma progressive after standard chemotherapy and treated with sunitinib 50 mg/d in 6-wk cycles of 4 wk on treatment followed by 2 wk off treatment(Schedule 4/2). In all three patients, sunitinib treatment was associated with a sustained disease control superior to 4 mo, patients achieving either a partial response or stable disease. A reduction in tumor size and density was observed in all cases, suggesting tumor necrosis as a result of sunitinib treatment in these patients. In addition, sunitinib was generally well tolerated and the occurrence of side effects was managed with standard medical interventions, as required. Our results suggest that sunitinib therapy maybe associated with favorable outcomes and tolerability in patients with advanced cholangiocarcinoma. Those observations contributed to launch a prospective phase Ⅱ multicenter trial investigating sunitinib in advanced intrahepatic cholangiocarcinoma(SUN-CK study; NCT01718327).展开更多
Many years after therapeutic wilderness, sorafenib finally showed a clinical benefit in patients with advanced hepatocellular carcinoma. After the primary general enthusiasm worldwide, some disappointments emerged par...Many years after therapeutic wilderness, sorafenib finally showed a clinical benefit in patients with advanced hepatocellular carcinoma. After the primary general enthusiasm worldwide, some disappointments emerged particularly since no new treatment could exceed or at least match sorafenib in this setting. Without these new drugs, research focused on optimi-zing care of patients treated with sorafenib. One challenging research approach deals with identifying prognostic and predictive biomarkers of sorafenib in this population. The task still seems difficult; however appropriate investigations could resolve this dilemma, as observed for some malignancies where other drugs were used.展开更多
The collaboration among various Italian scientific societies to establish recommendations for the surgical management of hepatocellular carcinoma(HCC),recently published in Digestive and Liver Disease(1),is a worthy e...The collaboration among various Italian scientific societies to establish recommendations for the surgical management of hepatocellular carcinoma(HCC),recently published in Digestive and Liver Disease(1),is a worthy effort.This multidisciplinary approach,which includes input from different disciplines such as surgery,hepatology,gastroenterology,oncology,pathology,radiology,and patient associations,underscores the commitment to placing patients at the center of care.Such a holistic and inclusive approach enhances the relevance and applicability of these guidelines in clinical practice.While several scientific associations have previously issued guidelines for managing HCC,the Italian colleagues have adopted a comprehensive methodology.展开更多
Sinn et al. (1) report the results of a multicenter trial comparing the combination of gemcitabine and erlotinib with gemcitabine alone for adjuvant therapy in 436 patients who underwent R0 resection for pancreatic du...Sinn et al. (1) report the results of a multicenter trial comparing the combination of gemcitabine and erlotinib with gemcitabine alone for adjuvant therapy in 436 patients who underwent R0 resection for pancreatic ductal carcinoma (PDAC).展开更多
文摘Advanced cholangiocarcinoma is associated with poor prognostic survival and has limited therapeutic options available at present. The importance of angiogenesis and expression of pro-angiogenic factors in intrahepatic forms of cholangiocarcinoma suggest that therapies targeting angiogenesis might be useful for the treatment of this disease. Here we report three cases of patients with advanced intrahepatic cholangiocarcinoma progressive after standard chemotherapy and treated with sunitinib 50 mg/d in 6-wk cycles of 4 wk on treatment followed by 2 wk off treatment(Schedule 4/2). In all three patients, sunitinib treatment was associated with a sustained disease control superior to 4 mo, patients achieving either a partial response or stable disease. A reduction in tumor size and density was observed in all cases, suggesting tumor necrosis as a result of sunitinib treatment in these patients. In addition, sunitinib was generally well tolerated and the occurrence of side effects was managed with standard medical interventions, as required. Our results suggest that sunitinib therapy maybe associated with favorable outcomes and tolerability in patients with advanced cholangiocarcinoma. Those observations contributed to launch a prospective phase Ⅱ multicenter trial investigating sunitinib in advanced intrahepatic cholangiocarcinoma(SUN-CK study; NCT01718327).
文摘Many years after therapeutic wilderness, sorafenib finally showed a clinical benefit in patients with advanced hepatocellular carcinoma. After the primary general enthusiasm worldwide, some disappointments emerged particularly since no new treatment could exceed or at least match sorafenib in this setting. Without these new drugs, research focused on optimi-zing care of patients treated with sorafenib. One challenging research approach deals with identifying prognostic and predictive biomarkers of sorafenib in this population. The task still seems difficult; however appropriate investigations could resolve this dilemma, as observed for some malignancies where other drugs were used.
文摘The collaboration among various Italian scientific societies to establish recommendations for the surgical management of hepatocellular carcinoma(HCC),recently published in Digestive and Liver Disease(1),is a worthy effort.This multidisciplinary approach,which includes input from different disciplines such as surgery,hepatology,gastroenterology,oncology,pathology,radiology,and patient associations,underscores the commitment to placing patients at the center of care.Such a holistic and inclusive approach enhances the relevance and applicability of these guidelines in clinical practice.While several scientific associations have previously issued guidelines for managing HCC,the Italian colleagues have adopted a comprehensive methodology.
文摘Sinn et al. (1) report the results of a multicenter trial comparing the combination of gemcitabine and erlotinib with gemcitabine alone for adjuvant therapy in 436 patients who underwent R0 resection for pancreatic ductal carcinoma (PDAC).
