RECIDIVA O PROGRESSIONE DI MALATTIA
CHEMIOTERAPIA SISTEMICA
v. schemi precedenti
CHIRURGIA
considerare un second look chirurgico in pazienti selezionati (sia basso che alto grado).
Valutare analisi IHC per NTRK (disponibili Entrectinib o Larotrectinib nel setting pretrattato in assenza di alternative terapeutiche valide).
MALATTIA METASTATICA EXTRA-PERITONEALE
Vedi trattamento dei tumori del colon destro metastatici
→ FOLFOX/XELOX ± Bevacizumaboff-label* (s.1,2,3,4)
→ FOLFIRI ± Bevacizumab off-label* (s. 5, 6)
→ Capecitabina ± Bevacizumab off-label* (s. 10)
* L'aggiunta del Bevacizumab sembra dare un vantaggio, in particolare nello PMP di alto grado. L'aggiunta dell’anti-EGFR non sembra dare un vantaggio, indipendentemente dallo stato mutazionale.
Riferimenti bibliografici principali:
- Lieu et al. "Systemic chemotherapy and surgical cytoreduction for poorly differentiated and signet ring cell adenocarcinomas of the appendix" Annals of oncology 2012
- Mohamedtaki et al. "Systemic therapy for advanced appendiceal adenocarcinoma: an analysis from NCCN oncology outcomes databases for colorectal cancer" JNCCN 2014
- Shapiro et al. "Modern systemic chemotherapy in surgically unresectable neoplasm of appendiceal origin" Cancer 2010
- Shaib et al. "Appendiceal mucinous neoplasm: diagnosis and management" The Oncologist 2017
- Bewan et al. Pseudomyxoma peritonei, WJCO 2010
- Marques et al. "Pseudomyxoma peritonei originating from appendix tumours" J Coloproctology 2018
- Smeenk et al. Pseudomyxoma peritonei, Cancer treatment reviews 2007
- Blackham et al. "Perioperative systemic chemotherapy for appendiceal mucinous carcinoma peritonei treated with cytoreductive surgery and hypertermic intraperitoneal chemotherapy" J Surg Oncol 2014
- Farqhuarson et al. "A phase II study evaluating the use of concurrent mitomycin C and capecitabine in patients with advanced unresectable pseudomyxoma peritonei" BJC 2008
- Choe et al. "Improved survival with anti-VEGF therapy in treatment of unresectable appendiceal epithelial neoplasms" Ann Surg Oncol 2015
- Pietrantonio et al. "FOLFOX-4 chemotherapy for patients with unresectable or relapsed peritoneal pseudomyxoma" Oncologist 2014
- Raimondi et al. "Metronomic Capecitabine with Cyclophosphamide regimen in unresectable or relapsed Pseudomyxoma Peritonei" Clinical Colorectal Cancer 2019
- LG AIOM 2021 Tumori peritoneali primitivi e secondari