膽管癌治療新進展

10.6666/ClinMed.202108_88(2).0088

李知育；陳天華；陳明晃

膽管癌（cholangiocarcinoma） ； 輔助性化學治療（adjuvant chemotherapy） ； 標靶治療（target therapy）

臨床醫學月刊

88卷2期（2021 / 08 / 27）

533 - 537

繁體中文

膽管癌為一預後相當差的惡性腫瘤，目前缺乏有效的治療組合，也因此，長期存活率始終偏低。ABC-02第三期試驗奠定了gemcitabine/cisplatin做為轉移性膽管癌的一線化學治療的角色，而後陸續有gemcitabine/TS-1，gemcitabine/ nab-Paclitaxel，gemcitabine/cisplatin/nab-Paclitaxel，Yttrium-90的嘗試，希望能夠推進第一線治療的療效。根據近幾年的流行病學統計，膽管癌的發生率有增加的趨勢。更有效的治療和長期疾病控制，已是迫在眉睫。隨著近年來對於膽管癌的突變特性的了解，以及標靶藥物的長足進展，目前已有FGFR標靶治療（infilgratinib、pemigatinib）、IDH1標靶治療（ivosidenib）、MEK標靶治療（selumetinib、dabrafenib/trametinib）等，於早期臨床試驗展現可能的治療潛力。這篇文章將介紹於「晚期和轉移性」膽管癌的治療，包括：輔助性化學治療的選擇、第一線與第二線化療藥物組合、膽管癌的基因突變、以及具有潛力的標靶藥物。

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