Translating the ABC-02 trial into daily practice: outcome of palliative treatment in patients with unresectable biliary tract cancer treated with gemcitabine and cisplatin

Dierks, J.; Gaspersz, M.; Belkouz, Ali; Vugt, Jeroen L.A. van; Coelen, Robert J.S.; Groot, J.W.B. de; Tije, Albert J. ten; Meijer, Willem; Pruijt, J.F.M.; Voorthuizen, Theo van; Spronsen, Dick Johan van; Rentinck, M.; Oever, Diederik ten; Smit, J. M.; Otten, Hans Martin; Gulik, Thomas M. van; Wilmink, Johanna W.; Koerkamp, Bas Groot; Klümpen, Heinz‐Josef

doi:10.1080/0284186x.2017.1418532

Cited by 27 publications

(21 citation statements)

References 12 publications

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“…Limited knowledge is available regarding appropriate chemotherapy dosing and management in patients with higher bilirubin levels. Treatment recommendations for patients with hyperbilirubinemia have been based on small phase I studies or retrospective patient series with heterogeneous study populations (4,5,8,(23)(24)(25)(26). It has been reported that an initial dose reduction is unnecessary for widely used gemcitabine or capecitabine in patients with biliary tract or pancreatic cancer after successful management of biliary obstruction, even with moderate hyperbilirubinemia (27,28).…”

Section: Discussionmentioning

confidence: 99%

Chemotherapy Improves Survival After Percutaneous Biliary Drainage in Patients With Pancreatic or Biliary Tract Cancer With Biliary Obstruction

Niemelä¹,

Syrjälä²,

Ohtonen³

et al. 2021

Anticancer Res

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Background: The survival benefit of chemotherapy compared to best supportive care (BSC) after percutaneous transhepatic biliary drainage (PTBD) was evaluated in patients with pancreatic or biliary tract cancer. Patients and Methods: A retrospective registry study was conducted at a tertiary-level university hospital. The endpoint was survival measured from the PTBD and the initiation of chemotherapy. Results: Among 158 patients (mean age=74 years, range=43-93 years; 51.9% women), 82 (51.9%) had pancreatic cancer and 76 (48.1%) had biliary tract cancer. After PTBD, 32 (20.3%) patients received chemotherapy and had a median survival of 11.7 months; 126 (79.7%) patients received only BSC resulting in a median survival of 1.7 months. The hazard ratio for survival at 1 year for patients who received chemotherapy compared to BSC was 0.22 (95% confidence interval=0.12-0.41, p<0.001). Conclusion: After PTBD, patients with pancreatic or biliary tract cancer should be critically evaluated by an oncologist to determine whether chemotherapy is possible, as it seems to significantly improve survival compared to BSC.

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Section: Discussionmentioning

confidence: 99%

Chemotherapy Improves Survival After Percutaneous Biliary Drainage in Patients With Pancreatic or Biliary Tract Cancer With Biliary Obstruction

Niemelä¹,

Syrjälä²,

Ohtonen³

et al. 2021

Anticancer Res

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“…In univariable Cox regression analysis ( (19) .669 SIRT 1 (<1) 1 (<1) 0 (0) 1.00 Systemic therapy 4 (2) NA 4 (6) .004 a p value applies to the 'meeting' versus 'not meeting' groups. p values <0.05 are highlighted in bold.…”

Section: Overall Survivalmentioning

confidence: 99%

“…Still, in absence of randomized-controlled trials, the exact benefit in patients not-meeting the SHARP eligibility criteria, specifically in Child-Pugh B patients, remains controversial. Real-life studies in some tumor types (i.e., colorectal and prostate cancer) have shown decreased outcomes when systemic therapies are given outside the landmark trial eligibility criteria [17,18], whereas outcomes were comparable in patients with bile tract cancer [19]. A direct comparison between SHARP eligible and non-eligible subgroups in advanced HCC has not been conducted.…”

Section: Introductionmentioning

confidence: 99%

Are we SHARP enough? The importance of adequate patient selection in sorafenib treatment for hepatocellular carcinoma

et al. 2018

Self Cite

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“…Due to the locally-aggressive growth pattern and late presentation as well as concerns for adequate future liver remnant (FLR) function and proximity to vital structures, an oncologic resection is only possible for approximately 20% of patients [ 1 , 9 , 10 ]. For unresectable disease, data from the multicenter phase III ABC-02 trial for treatment of advanced biliary tract cancers demonstrate a median overall patient survival of only 9.6 months, despite best medical therapy with gemcitabine and cisplatin [ 11 , 12 ]. Liver transplantation (LT) is emerging as an alternative treatment for select patients with favorable tumor biology.…”

Section: Introductionmentioning

confidence: 99%

The Role of Surgical Resection and Liver Transplantation for the Treatment of Intrahepatic Cholangiocarcinoma

Panayotova

Guerra

Guarrera

et al. 2021

JCM

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Intrahepatic cholangiocarcinoma (iCCA) is a rare and complex malignancy of the biliary epithelium. Due to its silent presentation, patients are frequently diagnosed late in their disease course, resulting in poor overall survival. Advances in molecular profiling and targeted therapies have improved medical management, but long-term survival is rarely seen with medical therapy alone. Surgical resection offers a survival advantage, but negative oncologic margins are difficult to achieve, recurrence rates are high, and the need for adequate future liver remnant limits the extent of resection. Advances in neoadjuvant and adjuvant treatments have broadened patient treatment options, and these agents are undergoing active investigation, especially in the setting of advanced, initially unresectable disease. For those who are not able to undergo resection, liver transplantation is emerging as a potential curative therapy in certain cases. Patient selection, favorable tumor biology, and a protocolized, multidisciplinary approach are ultimately necessary for best patient outcomes. This review will discuss the current surgical management of locally advanced, liver-limited intrahepatic cholangiocarcinoma as well as the role of liver transplantation for select patients with background liver disease.

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Translating the ABC-02 trial into daily practice: outcome of palliative treatment in patients with unresectable biliary tract cancer treated with gemcitabine and cisplatin

Cited by 27 publications

References 12 publications

Chemotherapy Improves Survival After Percutaneous Biliary Drainage in Patients With Pancreatic or Biliary Tract Cancer With Biliary Obstruction

Chemotherapy Improves Survival After Percutaneous Biliary Drainage in Patients With Pancreatic or Biliary Tract Cancer With Biliary Obstruction

Are we SHARP enough? The importance of adequate patient selection in sorafenib treatment for hepatocellular carcinoma

The Role of Surgical Resection and Liver Transplantation for the Treatment of Intrahepatic Cholangiocarcinoma

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