CAJ | 학술논문

随着胆道肿瘤基础研究的深入，分子靶向治疗成为新的热点。旨在对分子靶向治疗晚期胆道肿瘤的Ⅱ、Ⅲ临床试验作一综述，为临床实践提供新的思路。Ⅱ临床试验中，血管生长因子受体阻滞剂、有丝分裂原活化蛋白激酶阻滞剂没有体现良好的抗肿瘤活性，而表皮生长因子受体抑制剂对晚期胆道肿瘤显示出良好的安全性和有效性。唯一的一项Ⅲ期随机、开放、多中心对照研究表明尼洛替尼联合吉西他滨、奥沙利铂作为晚期胆道肿瘤一线治疗手段未能显著改善患者的总体生存。亚组分析胆管癌能从标准化疗联合尼洛替尼获得显著的无疾病进展生存时间。通过分析认为表皮生长因子受体抑制剂有效地控制胆道肿瘤进展，有望成为靶向治疗的新方向。
수착담도종류기출연구적심입，분자파향치료성위신적열점。지재대분자파향치료만기담도종류적Ⅱ、Ⅲ림상시험작일종술，위림상실천제공신적사로。Ⅱ림상시험중，혈관생장인자수체조체제、유사분렬원활화단백격매조체제몰유체현량호적항종류활성，이표피생장인자수체억제제대만기담도종류현시출량호적안전성화유효성。유일적일항Ⅲ기수궤、개방、다중심대조연구표명니락체니연합길서타빈、오사리박작위만기담도종류일선치료수단미능현저개선환자적총체생존。아조분석담관암능종표준화료연합니락체니획득현저적무질병진전생존시간。통과분석인위표피생장인자수체억제제유효지공제담도종류진전，유망성위파향치료적신방향。
Molecular targeted therapy has become a new hot spot with the in -depth basic research on advanced biliary tract cancer (ABTC).Phase ⅡandⅢtrials of the molecular targeted therapies for ABTC are summarized to provide new insights into clinical practice. Phase II trials have shown that vascular endothelial growth factor receptor inhibitor and mitogen-activated protein kinase inhibitor do not ex-hibit good anti-tumor activity,but epidermal growth factor receptor (EGFR)inhibitor has proven to be safe and effective in the treatment of ABTC.The only multicenter,open-label,randomized,controlled phase Ⅲ trial has shown that nilotinib combined with gemcitabine and oxaliplatin,as the first-line chemotherapy for ABTC,cannot significantly increase the overall survival in patients.Subgroup analysis has shown that standard chemotherapy combined with nilotinib can significantly increase the progression-free survival in patients.These results indicate that EGFR inhibitor is effective to control the progression of ABTC,suggesting that EGFR might be a novel therapeutic target.