Japanese

Title	切除不能膵癌に対する化学療法
Subtitle	特集 膵癌診療ガイドライン2019改訂のポイント
Authors	古瀬純司1), 井岡達也2), 福冨晃3), 水野伸匡4), 尾阪将人5), 奥坂拓志6)
Authors (kana)
Organization	1)杏林大学医学部腫瘍内科学, 2)大阪国際がんセンター検診部消化器検診科, 3)静岡県立静岡がんセンター消化器内科, 4)愛知県がんセンター消化器内科部, 5)がん研有明病院消化器センター肝胆膵内科, 6)国立がん研究センター中央病院肝胆膵内科
Journal	膵臓
Volume	35
Number	1
Page	69-74
Year/Month	2020 /
Article	報告
Publisher	日本膵臓学会
Abstract	「要旨:」切除不能膵癌に対する化学療法は, 局所進行と遠隔転移を分けた推奨と, 化学療法の継続期間について検討した. 遠隔転移例に対する1次化学療法では, ゲムシタビン(GEM)単独を対照としたFOLFIRINOX療法, あるいはGEM+ナブパクリタキセル併用療法による第III相試験により生存期間の延長が証明された. その結果, この2つが遠隔転移例に対する第一選択の治療として推奨されている. 局所進行例ではこれらの治療法は十分なエビデンスがないものの, GEM単独あるいはS-1単独と同レベルで推奨されている. 2次化学療法は延命効果が示されており, 実施することが推奨され, 1次化学療法に応じてフルオロウラシル関連あるいはGEM関連レジメンを用いる. 高頻度マイクロサテライト不安定性であればペムブロリズマブの有効性が期待できる. 化学療法は継続困難な有害事象の発現または病態の明らかな進行まで継続することが適当である.
Practice	臨床医学：内科系
Keywords	膵癌, 遠隔転移, 切除不能局所進行, 化学療法, Pancreatic cancer, Metastatic disease, Unresectable locally advanced disease, Chemotherapy

English

Title	Chemotherapy for patients with unresesctable pancreatic cancer is recommended in the Clinical Practice Guidelines for Pancreatic Cancer 2019
Subtitle
Authors	Junji FURUSE1), Tatsuya IOKA2), Akira FUKUTOMI3), Nobumasa MIZUNO4), Masato OZAKA5), Takuji OKUSAKA6)
Authors (kana)
Organization	1)Department of Medical Oncology, Kyorin University Faculty of Medicine, 2)Department of Cancer Survey and Gastrointestinal Oncology, Osaka International Cancer Institute, 3)Department of Gastrointestinal Oncology, Shizuoka Cancer Center, 4)Department of Gastroenterology, Aichi Cancer Center Hospital, 5)Department of Gastroenterology, the Cancer Institute Hospital of Japanese Foundation for Cancer Research, 6)Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital
Journal	Journal of the Japan Pancreas Society
Volume	35
Number	1
Page	69-74
Year/Month	2020 /
Article	Report
Publisher	Japan Pancreas Society
Abstract	Unresectable pancreatic cancer can be classified as locally advanced or metastatic, and the Clinical Practice Guidelines for Pancreatic Cancer 2019 recommend chemotherapy for patients with unresectable pancreatic cancer based on this classification. The optimal duration of chemotherapy is also recommended in the guidelines. Phase IIII trials of first-line chemotherapy, FOLFIRINOX or gemcitabine plus nab-paclitaxel (GnP) as compared to gemcitabine alone, have demonstrated that FOLFIRINOX or GnP offer prolonged overall survival as compared to gemcitabine alone, in patients with metastatic pancreatic cancer. Therefore, the two regimens are recommended as the first treatment of choice for patients with metastatic disease. Although no randomized controlled trials of FOLFIRINOX or GnP have been conducted to date for locally advanced pancreatic cancer, these two regimens are also recommended for the treatment of locally advanced disease at the same level as gemcitabine monotherapy or S-1 monotherapy. Since second-line chemotherapy was proven to offer a survival benefit over supportive care in a randomized controlled trial, second-line chemotherapy is also recommended for patients with advanced pancreatic cancer. A fluoropyrimidine-based regimen is recommended after first-line use of a gemcitabine-based regimen, and a gemcitabine-based regimen is recommended after first-line use of a fluoropyrimidine-based regimen, such as FOLFIRINOX or S-1 chemotherapy. Pembrolizumab, a programmed cell death ligand-1 inhibitor, is also recommended to treat tumors with high microsatellite instability, including pancreatic cancer. Chemotherapy should be continued until detection of progressive disease or emergence of intolerable adverse events.
Practice	Clinical internal medicine
Keywords	Pancreatic cancer, Metastatic disease, Unresectable locally advanced disease, Chemotherapy

• 全文ダウンロード： 従量制、基本料金制の方共に770円(税込) です。

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