Skip to main content
SpringerLink
Log in

Therapie des metastasierten Cholangiokarzinoms

Therapy of metastasized cholangiocarcinoma

  • Leitthema
  • Published:
Der Onkologe Aims and scope

Zusammenfassung

Hintergrund

Das Cholangiokarzinom (CCA) ist die zweithäufigste primäre maligne Lebererkrankung nach dem Leberzellkarzinom.

Methode

Diese Arbeit basiert auf einer selektiven Literaturrecherche in der Datenbank Pubmed zur Behandlung des metastasierten CCA.

Ziel

In diesem Artikel werden aktuelle palliative Chemotherapiekonzepte sowie neue medikamentöse und lokoregionäre Therapien erläutert.

Ergebnisse

Zum Zeitpunkt der Diagnose sind aufgrund von lokal fortgeschrittenen Tumoren oder Fernmetastasen mehr als die Hälfte der Patienten keine Kandidaten mehr für eine kurative chirurgische Therapie. Während der letzten Jahrzehnte sind in der Onkologie verschiedene neuartige Therapien eingeführt worden. Nichtsdestotrotz ist die Anzahl von Therapiemöglichkeiten beim CCA weiterhin limitiert.

Abstract

Background

Cholangiocarcinoma (CCA) is the second most common primary malignant liver disease after hepatocellular carcinoma.

Method

This review is based on a selective PubMed search of the literature on the treatment of CCA.

Objective

In this article current palliative chemotherapy concepts, as well as new drug and locoregional therapies are explained.

Results

At the time of diagnosis more than half of the patients are no longer candidates for curative surgical therapy due to locally advanced tumors or distant metastases. During the last decades, various novel therapies have been introduced in the field of oncology; nevertheless, the number of treatment options for CCA is still limited.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1

Literatur

  1. Hahn T von et al (2011) Epidemiological trends in incidence and mortality of hepatobiliary cancers in Germany. Scand J Gastroenterol 46(9):1092–1098

    Article  Google Scholar 

  2. Wang Y et al (2013) Prognostic nomogram for intrahepatic cholangiocarcinoma after partial hepatectomy. J Clin Oncol 31(9):1188–1195

    Article  PubMed  Google Scholar 

  3. Eckel F, Schmid RM (2007) Chemotherapy in advanced biliary tract carcinoma: a pooled analysis of clinical trials. Br J Cancer 96(6):896–902

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  4. Sharma A et al (2010) A phase II study of gemcitabine and oxaliplatin (Oxigem) in unresectable gall bladder cancer. Cancer Chemother Pharmacol 65(3):497–502

    Article  CAS  PubMed  Google Scholar 

  5. Gelibter A et al (2005) Fixed dose-rate gemcitabine infusion as first-line treatment for advanced-stage carcinoma of the pancreas and biliary tree. Cancer 104(6):1237–1245

    Article  CAS  PubMed  Google Scholar 

  6. Rao S et al (2005) Phase III study of 5FU, etoposide and leucovorin (FELV) compared to epirubicin, cisplatin and 5FU (ECF) in previously untreated patients with advanced biliary cancer. Br J Cancer 92(9):1650–1654

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  7. Walter T et al (2013) Feasibility and benefits of second-line chemotherapy in advanced biliary tract cancer: a large retrospective study. Eur J Cancer 49(2):329–335

    Article  PubMed  Google Scholar 

  8. Lamarca A et al (2014) Second-line chemotherapy in advanced biliary cancer: a systematic review. Ann Oncol 25(12):2328–2338

    Article  CAS  PubMed  Google Scholar 

  9. Gruenberger B et al (2010) Cetuximab, gemcitabine, and oxaliplatin in patients with unresectable advanced or metastatic biliary tract cancer: a phase 2 study. Lancet Oncol 11(12):1142–1148

    Article  CAS  PubMed  Google Scholar 

  10. Chen JS et al (2015) A KRAS mutation status-stratified randomized phase II trial of gemcitabine and oxaliplatin alone or in combination with cetuximab in advanced biliary tract cancer. Ann Oncol 26(5):943–949

    Article  CAS  PubMed  Google Scholar 

  11. Lee J et al (2012) Gemcitabine and oxaliplatin with or without erlotinib in advanced biliary-tract cancer: a multicentre, open-label, randomised, phase 3 study. Lancet Oncol 13(2):181–188

    Article  CAS  PubMed  Google Scholar 

  12. Lubner SJ et al (2010) Report of a multicenter phase II trial testing a combination of biweekly bevacizumab and daily erlotinib in patients with unresectable biliary cancer: a phase II Consortium study. J Clin Oncol 28(21):3491–3497

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  13. Zhu AX et al (2010) Efficacy and safety of gemcitabine, oxaliplatin, and bevacizumab in advanced biliary-tract cancers and correlation of changes in 18-fluorodeoxyglucose PET with clinical outcome: a phase 2 study. Lancet Oncol 11(1):48–54

    Article  CAS  PubMed  Google Scholar 

  14. Moehler M et al (2014) Gemcitabine plus sorafenib versus gemcitabine alone in advanced biliary tract cancer: a double-blind placebo-controlled multicentre phase II AIO study with biomarker and serum programme. Eur J Cancer 50(18):3125–3135

    Article  CAS  PubMed  Google Scholar 

  15. Yi JH et al (2012) A phase II study of sunitinib as a second-line treatment in advanced biliary tract carcinoma: a multicentre, multinational study. Eur J Cancer 48(2):196–201

    Article  CAS  PubMed  Google Scholar 

  16. Santoro A et al (2015) A randomized, multicenter, phase II study of vandetanib monotherapy versus vandetanib in combination with gemcitabine versus gemcitabine plus placebo in subjects with advanced biliary tract cancer: the VanGogh study. Ann Oncol 26(3):542–547

    Article  CAS  PubMed  Google Scholar 

  17. Bekaii-Saab T et al (2011) Multi-institutional phase II study of selumetinib in patients with metastatic biliary cancers. J Clin Oncol 29(17):2357–2363

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  18. Sasaki T et al (2013) A randomized phase II study of gemcitabine and S-1 combination therapy versus gemcitabine monotherapy for advanced biliary tract cancer. Cancer Chemother Pharmacol 71(4):973–979

    Article  CAS  PubMed  Google Scholar 

  19. Mertens JC et al (2013) Therapeutic effects of deleting cancer-associated fibroblasts in cholangiocarcinoma. Cancer Res 73(2):897–907

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  20. Zender S et al (2013) A critical role for notch signaling in the formation of cholangiocellular carcinomas. Cancer Cell 23(6):784–795

    Article  CAS  PubMed  Google Scholar 

  21. El Khatib M et al (2013) Activation of Notch signaling is required for cholangiocarcinoma progression and is enhanced by inactivation of p53 in vivo. PLoS One 8(10):e77433

    Article  Google Scholar 

  22. Yang N et al (2015) Matrine suppresses proliferation and induces apoptosis in human cholangiocarcinoma cells through suppression of JAK2/STAT3 signaling. Pharmacol Rep 67(2):388–393

    Article  CAS  PubMed  Google Scholar 

  23. Gradilone SA et al (2013) HDAC6 inhibition restores ciliary expression and decreases tumor growth. Cancer Res 73(7):2259–2270

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  24. Ibrahim SM et al (2008) Treatment of unresectable cholangiocarcinoma using yttrium-90 microspheres: results from a pilot study. Cancer 113(8):2119–2128

    Article  CAS  PubMed  Google Scholar 

  25. Turkmen C et al (2013) Initial outcome after selective intraarterial radionuclide therapy with yttrium-90 microspheres as salvage therapy for unresectable metastatic liver disease. Cancer Biother Radiopharm 28(7):534–540

    Article  CAS  PubMed  Google Scholar 

  26. Rafi S et al (2013) Yttrium-90 radioembolization for unresectable standard-chemorefractory intrahepatic cholangiocarcinoma: survival, efficacy, and safety study. Cardiovasc Intervent Radiol 36(2):440–448

    Article  PubMed  Google Scholar 

  27. Gusani NJ et al (2008) Treatment of unresectable cholangiocarcinoma with gemcitabine-based transcatheter arterial chemoembolization (TACE): a single-institution experience. J Gastrointest Surg 12(1):129–137

    Article  PubMed  Google Scholar 

  28. Park SY et al (2011) Transarterial chemoembolization versus supportive therapy in the palliative treatment of unresectable intrahepatic cholangiocarcinoma. Clin Radiol 66(4):322–328

    Article  PubMed  Google Scholar 

  29. Kuhlmann JB et al (2012) Treatment of unresectable cholangiocarcinoma: conventional transarterial chemoembolization compared with drug eluting bead-transarterial chemoembolization and systemic chemotherapy. Eur J Gastroenterol Hepatol 24(4):437–443

    CAS  PubMed  Google Scholar 

  30. Valle et al. ASCO 2014

Download references

Einhaltung ethischer Richtlinien

Interessenkonflikt. A. Vogel und R.R. Plentz geben an, dass kein Interessenkonflikt besteht.

Der Beitrag enthält keine Studien an Menschen oder Tieren.

Author information

Authors and Affiliations

  1. Abteilung Innere Medizin 1, Medizinische Universitätsklinik, Tübingen, Deutschland

    R.R. Plentz

  2. Klinik für Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland

    A. Vogel

Authors
  1. R.R. Plentz
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Vogel
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A. Vogel.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Plentz, R., Vogel, A. Therapie des metastasierten Cholangiokarzinoms. Onkologe 21, 1064–1068 (2015). https://doi.org/10.1007/s00761-015-2932-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00761-015-2932-2

Schlüsselwörter

Keywords

Search

Navigation