Outcomes in patients receiving palliative chemotherapy for advanced biliary tract cancer

Felix Thol; Simon Johannes Gairing; Carolin Czauderna; Thomas Thomaidis; Thomas Gamstätter; Yvonne Huber; Johanna Vollmar; Johanna Lorenz; Maurice Michel; Fabian Bartsch; Lukas Müller; Roman Kloeckner; Peter Robert Galle; Marcus Alexander Wörns; Jens Uwe Marquardt; Markus Moehler; Arndt Weinmann; Friedrich Foerster

doi:10.1016/j.jhepr.2021.100417

Outcomes in patients receiving palliative chemotherapy for advanced biliary tract cancer

Felix Thol, Simon Johannes Gairing, Carolin Czauderna, Thomas Thomaidis, Thomas Gamstätter, Yvonne Huber, Johanna Vollmar, Johanna Lorenz, Maurice Michel, Fabian Bartsch, Lukas Müller, Roman Kloeckner, Peter Robert Galle, Marcus Alexander Wörns, Jens Uwe Marquardt, Markus Moehler, Arndt Weinmann, Friedrich Foerster^*

^*Corresponding author for this work

2 Citations (Scopus)

Abstract

Background & Aims: Advanced biliary tract cancer (ABTC) is associated with a poor prognosis. Real-world data on the outcome of patients with ABTC undergoing sequential chemotherapies remain scarce, and little is known about treatment options beyond the established first- and second-line treatments with gemcitabine + cisplatin and FOLFOX. This study aimed to evaluate the outcome of patients with regard to different oncological therapies and to identify prognostic factors. Methods: From January 2010 until December 2019, 142 patients started palliative chemotherapy at our tertiary care liver center. Overall survival (OS) was calculated using Kaplan-Meier plots. Prognostic factors were evaluated using cox proportional-hazards. Results: Patients received a median number of 2 lines of chemotherapy. Median OS was 6.7, 15.2 and 18.2 months for patients who received 1, 2 and 3 lines of chemotherapy, respectively. Patients treated with FOLFIRINOX had a significantly extended OS of 23.8 months (log-rank test: p = 0.018). The univariate cox regression analysis identified several clinical parameters associated with survival (e.g. albumin, bilirubin, carcinoembryonic antigen, carbohydrate antigen 19-9 levels). Conclusions: Our study provides real-world data on the prognosis of ABTC including survival times for patients receiving third and later lines of chemotherapy. Lay summary: Real-world data depicting the outcome of patients with advanced biliary tract cancer outside the framework of controlled trials remain rare despite being extremely important for clinical decision-making. This study therefore provides important real-world data on the established first- and second-line treatments with gemcitabine + cisplatin and FOLFOX, as well as on other chemotherapy regimens or later lines of chemotherapy. It further demonstrates that the use of FOLFIRINOX is associated with promising survival and that there is an association between various clinical parameters such as pre-therapeutic albumin, bilirubin or carbohydrate antigen 19-9 levels and survival.

Original language	English
Article number	100417
Journal	JHEP Reports
Volume	4
Issue number	3
ISSN	2589-5559
DOIs	https://doi.org/10.1016/j.jhepr.2021.100417
Publication status	Published - 03.2022

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10.1016/j.jhepr.2021.100417

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Thol, F., Gairing, S. J., Czauderna, C., Thomaidis, T., Gamstätter, T., Huber, Y., Vollmar, J., Lorenz, J., Michel, M., Bartsch, F., Müller, L., Kloeckner, R., Galle, P. R., Wörns, M. A., Marquardt, J. U., Moehler, M., Weinmann, A., & Foerster, F. (2022). Outcomes in patients receiving palliative chemotherapy for advanced biliary tract cancer. JHEP Reports, 4(3), Article 100417. https://doi.org/10.1016/j.jhepr.2021.100417

@article{96fc963462d04f299d10e8b6c52955b2,

title = "Outcomes in patients receiving palliative chemotherapy for advanced biliary tract cancer",

abstract = "Background & Aims: Advanced biliary tract cancer (ABTC) is associated with a poor prognosis. Real-world data on the outcome of patients with ABTC undergoing sequential chemotherapies remain scarce, and little is known about treatment options beyond the established first- and second-line treatments with gemcitabine + cisplatin and FOLFOX. This study aimed to evaluate the outcome of patients with regard to different oncological therapies and to identify prognostic factors. Methods: From January 2010 until December 2019, 142 patients started palliative chemotherapy at our tertiary care liver center. Overall survival (OS) was calculated using Kaplan-Meier plots. Prognostic factors were evaluated using cox proportional-hazards. Results: Patients received a median number of 2 lines of chemotherapy. Median OS was 6.7, 15.2 and 18.2 months for patients who received 1, 2 and 3 lines of chemotherapy, respectively. Patients treated with FOLFIRINOX had a significantly extended OS of 23.8 months (log-rank test: p = 0.018). The univariate cox regression analysis identified several clinical parameters associated with survival (e.g. albumin, bilirubin, carcinoembryonic antigen, carbohydrate antigen 19-9 levels). Conclusions: Our study provides real-world data on the prognosis of ABTC including survival times for patients receiving third and later lines of chemotherapy. Lay summary: Real-world data depicting the outcome of patients with advanced biliary tract cancer outside the framework of controlled trials remain rare despite being extremely important for clinical decision-making. This study therefore provides important real-world data on the established first- and second-line treatments with gemcitabine + cisplatin and FOLFOX, as well as on other chemotherapy regimens or later lines of chemotherapy. It further demonstrates that the use of FOLFIRINOX is associated with promising survival and that there is an association between various clinical parameters such as pre-therapeutic albumin, bilirubin or carbohydrate antigen 19-9 levels and survival.",

author = "Felix Thol and Gairing, {Simon Johannes} and Carolin Czauderna and Thomas Thomaidis and Thomas Gamst{\"a}tter and Yvonne Huber and Johanna Vollmar and Johanna Lorenz and Maurice Michel and Fabian Bartsch and Lukas M{\"u}ller and Roman Kloeckner and Galle, {Peter Robert} and W{\"o}rns, {Marcus Alexander} and Marquardt, {Jens Uwe} and Markus Moehler and Arndt Weinmann and Friedrich Foerster",

note = "Publisher Copyright: {\textcopyright} 2021 The Author(s)",

year = "2022",

month = mar,

doi = "10.1016/j.jhepr.2021.100417",

language = "English",

volume = "4",

journal = "JHEP Reports",

issn = "2589-5559",

number = "3",

}

Thol, F, Gairing, SJ, Czauderna, C, Thomaidis, T, Gamstätter, T, Huber, Y, Vollmar, J, Lorenz, J, Michel, M, Bartsch, F, Müller, L, Kloeckner, R, Galle, PR, Wörns, MA, Marquardt, JU, Moehler, M, Weinmann, A & Foerster, F 2022, 'Outcomes in patients receiving palliative chemotherapy for advanced biliary tract cancer', JHEP Reports, vol. 4, no. 3, 100417. https://doi.org/10.1016/j.jhepr.2021.100417

TY - JOUR

T1 - Outcomes in patients receiving palliative chemotherapy for advanced biliary tract cancer

AU - Thol, Felix

AU - Gairing, Simon Johannes

AU - Czauderna, Carolin

AU - Thomaidis, Thomas

AU - Gamstätter, Thomas

AU - Huber, Yvonne

AU - Vollmar, Johanna

AU - Lorenz, Johanna

AU - Michel, Maurice

AU - Bartsch, Fabian

AU - Müller, Lukas

AU - Kloeckner, Roman

AU - Galle, Peter Robert

AU - Wörns, Marcus Alexander

AU - Marquardt, Jens Uwe

AU - Moehler, Markus

AU - Weinmann, Arndt

AU - Foerster, Friedrich

PY - 2022/3

Y1 - 2022/3

N2 - Background & Aims: Advanced biliary tract cancer (ABTC) is associated with a poor prognosis. Real-world data on the outcome of patients with ABTC undergoing sequential chemotherapies remain scarce, and little is known about treatment options beyond the established first- and second-line treatments with gemcitabine + cisplatin and FOLFOX. This study aimed to evaluate the outcome of patients with regard to different oncological therapies and to identify prognostic factors. Methods: From January 2010 until December 2019, 142 patients started palliative chemotherapy at our tertiary care liver center. Overall survival (OS) was calculated using Kaplan-Meier plots. Prognostic factors were evaluated using cox proportional-hazards. Results: Patients received a median number of 2 lines of chemotherapy. Median OS was 6.7, 15.2 and 18.2 months for patients who received 1, 2 and 3 lines of chemotherapy, respectively. Patients treated with FOLFIRINOX had a significantly extended OS of 23.8 months (log-rank test: p = 0.018). The univariate cox regression analysis identified several clinical parameters associated with survival (e.g. albumin, bilirubin, carcinoembryonic antigen, carbohydrate antigen 19-9 levels). Conclusions: Our study provides real-world data on the prognosis of ABTC including survival times for patients receiving third and later lines of chemotherapy. Lay summary: Real-world data depicting the outcome of patients with advanced biliary tract cancer outside the framework of controlled trials remain rare despite being extremely important for clinical decision-making. This study therefore provides important real-world data on the established first- and second-line treatments with gemcitabine + cisplatin and FOLFOX, as well as on other chemotherapy regimens or later lines of chemotherapy. It further demonstrates that the use of FOLFIRINOX is associated with promising survival and that there is an association between various clinical parameters such as pre-therapeutic albumin, bilirubin or carbohydrate antigen 19-9 levels and survival.

AB - Background & Aims: Advanced biliary tract cancer (ABTC) is associated with a poor prognosis. Real-world data on the outcome of patients with ABTC undergoing sequential chemotherapies remain scarce, and little is known about treatment options beyond the established first- and second-line treatments with gemcitabine + cisplatin and FOLFOX. This study aimed to evaluate the outcome of patients with regard to different oncological therapies and to identify prognostic factors. Methods: From January 2010 until December 2019, 142 patients started palliative chemotherapy at our tertiary care liver center. Overall survival (OS) was calculated using Kaplan-Meier plots. Prognostic factors were evaluated using cox proportional-hazards. Results: Patients received a median number of 2 lines of chemotherapy. Median OS was 6.7, 15.2 and 18.2 months for patients who received 1, 2 and 3 lines of chemotherapy, respectively. Patients treated with FOLFIRINOX had a significantly extended OS of 23.8 months (log-rank test: p = 0.018). The univariate cox regression analysis identified several clinical parameters associated with survival (e.g. albumin, bilirubin, carcinoembryonic antigen, carbohydrate antigen 19-9 levels). Conclusions: Our study provides real-world data on the prognosis of ABTC including survival times for patients receiving third and later lines of chemotherapy. Lay summary: Real-world data depicting the outcome of patients with advanced biliary tract cancer outside the framework of controlled trials remain rare despite being extremely important for clinical decision-making. This study therefore provides important real-world data on the established first- and second-line treatments with gemcitabine + cisplatin and FOLFOX, as well as on other chemotherapy regimens or later lines of chemotherapy. It further demonstrates that the use of FOLFIRINOX is associated with promising survival and that there is an association between various clinical parameters such as pre-therapeutic albumin, bilirubin or carbohydrate antigen 19-9 levels and survival.

UR - http://www.scopus.com/inward/record.url?scp=85123169463&partnerID=8YFLogxK

U2 - 10.1016/j.jhepr.2021.100417

DO - 10.1016/j.jhepr.2021.100417

M3 - Journal articles

AN - SCOPUS:85123169463

SN - 2589-5559

VL - 4

JO - JHEP Reports

JF - JHEP Reports

IS - 3

M1 - 100417

ER -

Outcomes in patients receiving palliative chemotherapy for advanced biliary tract cancer

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