Systemic treatment options for advanced biliary tract carcinoma

Xie, Changqing; McGrath, Nicole A; Bonilla, Cecilia Monge; Fu, Jianyang

doi:10.1007/s00535-020-01712-9

Cited by 17 publications

(17 citation statements)

References 122 publications

(147 reference statements)

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“…Thus, routine use of checkpoint inhibitors outside of clinical trials should not be recommended [ 28 ]. Because of the relative rarity and heterogeneity of GBA subtypes [ 30 ], there are few randomized prospective studies to determine the optimal treatment strategy for patients with advanced stage. Although targeted therapy and immunotherapy are in the exploratory stage, the identification of new targets and the development of new molecules are likely to make "Precision Medicine" a newly promising treatment for patients with advanced GBA.…”

Section: Discussionmentioning

confidence: 99%

Site-specific metastases of gallbladder adenocarcinoma and their prognostic value for survival: a SEER-based study

Yang

et al. 2021

BMC Surg

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Background Gallbladder cancer is a rare but highly malignant cancer, which often progresses to a metastatic stage when diagnosed because of its asymptomatic manifestation. In this study, we intended to analyze the prognostic value of metastatic gallbladder adenocarcinoma (GBA) with site-specific metastases. Methods Using the Surveillance, Epidemiology, and End Results (SEER) database, GBA patients diagnosed with metastases between 2010 and 2016 were selected to identify the prognosis according to the isolated metastatic sites, including liver, lung, bone, brain and distant lymph nodes (DL). Kaplan–Meier methods were used for survival comparisons and multivariable Cox regression models were constructed to find out independent factors that associated with survival. Results Data from 1526 eligible patients were extracted from the SEER database. Among the patients, 788 (51.6%) had isolated liver metastases, 80 (5.2%) had isolated distant nodal involvement, 45 (2.9%) had isolated lung metastases, 21 (1.4%) had isolated bone metastases, 2 (0.1%) had isolated brain metastases and 590 (38.7%) had multiple metastases. No significant survival difference was shown between patients with single or multisite metastases (P > 0.05). Patients with isolated lung or DL metastases had significant better survival outcomes than those with isolated bone metastases (P < 0.05). Multivariate analysis showed that performing surgery at primary site, receiving chemotherapy were associated with better OS and CSS for patients with isolated liver or DL metastases. Conclusions The study showed that different metastatic sites affect survival outcomes in metastatic GBA patients. Highly selected subset of patients with liver or DL metastases might benefit from surgery at primary site.

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Section: Discussionmentioning

confidence: 99%

Site-specific metastases of gallbladder adenocarcinoma and their prognostic value for survival: a SEER-based study

Yang

et al. 2021

BMC Surg

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show abstract

Section: Discussionmentioning

confidence: 99%

“…In recent years, molecular-targeted therapy, immunotherapy, and multidrug combination therapy have shown interesting and attractive results ( 16 , 17 ). Molecular-targeted agents, including vascular epidermal growth factor (VEGF) inhibitors, fibroblast growth factor (FGF) inhibitors, and isocitrate dehydrogenase (IDH) inhibitors, have provided new ideas for further treatment in advanced ICC ( 9 , 17 , 18 ). Lenvatinib, confirmed as an inhibitor of VEGF receptors 1–3, FGF receptors 1–4, platelet-derived growth factor (PDGF) receptor α, KIT, and RET, selectively inhibits receptor tyrosine kinases involved in tumor growth and angiogenesis ( 19 , 20 ).…”

Section: Discussionmentioning

confidence: 99%

Systemic Sequential Therapy of CisGem, Tislelizumab, and Lenvatinib for Advanced Intrahepatic Cholangiocarcinoma Conversion Therapy

et al. 2021

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Intrahepatic cholangiocarcinoma (CCA), always diagnosed at an advanced stage in recent years, is of high aggression and poor prognosis. There is no standard treatment beyond first-line chemotherapy and no molecular-targeted agents or immune checkpoint inhibitors approved for advanced intrahepatic CCA. Hence, we firstly report an original therapeutic strategy for a 60-year-old patient diagnosed with intrahepatic CCA categorized as Stage IIIB (T3N1M0) by the American Joint Committee on Cancer staging system. After histopathological examination and next-generation sequencing, the patient was treated with four courses of novel systemic sequential therapy (intravenous gemcitabine 1,000 mg/m2 and cisplatin 25 mg/m2 on days 1 and 8; oral lenvatinib 8 mg/day from days 1 to 21; intravenous tislelizumab 200 mg on day 15). Then, the patient achieved partial response and was operated on right hemihepatectomy, cholecystectomy, and abdominal lymph node dissection. Without any perioperative complications, the patient was discharged from our hospital in perfect condition. Thereafter, the patient continued to use this new regimen 1 month after surgery for adjuvant therapy and was confirmed without recurrence when we followed up. In a word, we found an effective therapeutic regimen for preoperative advanced intrahepatic CCA conversion therapy, which may become a new approach in cancer treatment in the future.

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“…29 Thus, routine use of checkpoint inhibitors outside of clinical trials should not be recommended. 28 Because of the relative rarity and heterogeneity of GBA subtypes, 30 there are few randomized prospective studies to determine the optimal treatment strategy for patients with advanced stage.…”

Section: Discussionmentioning

confidence: 99%

Site-specific metastases of gallbladder adenocarcinoma and their prognostic value for survival: a SEER-based study

Yang

et al. 2021

Preprint

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Background: Gallbladder cancer is a rare but highly malignant cancer, which often progresses to a metastatic stage when diagnosed because of its asymptomatic manifestation. In this study, we intended to analyze the prognostic value of metastatic gallbladder adenocarcinoma (GBA) with site-specific metastases.Methods: Using the Surveillance, Epidemiology, and End Results (SEER) database, GBA patients diagnosed with metastases between 2010 and 2016 were selected to identify the prognosis according to the isolated metastatic sites, including liver, lung, bone, brain and distant lymph nodes (DL). Kaplan-Meier methods were used for survival comparisons and multivariable Cox regression models were constructed to find out independent factors that associated with survival.Results: Data from 1526 eligible patients were extracted from the SEER database. Among the patients, 788 (51.6%) had isolated liver metastases, 80 (5.2%) had isolated distant nodal involvement, 45 (2.9%) had isolated lung metastases, 21 (1.4%) had isolated bone metastases, 2 (0.1%) had isolated brain metastases and 590 (38.7%) had multiple metastases. No significant survival difference was shown between patients with single or multisite metastases (P>0.05). Patients with isolated lung or DL metastases had significant better survival outcomes than those with isolated bone metastases (P<0.05). Multivariate analysis showed that performing surgery at primary site, receiving chemotherapy were associated with better OS and CSS for patients with isolated liver or DL metastases.Conclusions: The study showed that different metastatic sites affect survival outcomes in metastatic GBA patients. Highly selected subset of patients with liver or DL metastases might benefit from surgery at primary site.

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Systemic treatment options for advanced biliary tract carcinoma

Cited by 17 publications

References 122 publications

Site-specific metastases of gallbladder adenocarcinoma and their prognostic value for survival: a SEER-based study

Site-specific metastases of gallbladder adenocarcinoma and their prognostic value for survival: a SEER-based study

Systemic Sequential Therapy of CisGem, Tislelizumab, and Lenvatinib for Advanced Intrahepatic Cholangiocarcinoma Conversion Therapy

Site-specific metastases of gallbladder adenocarcinoma and their prognostic value for survival: a SEER-based study

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