Advances in the treatment of metastatic or unresectable biliary tract cancer.
Authors
Valle, Juan WAffiliation
Christie Hospital/The University of Manchester, Manchester, UK.Issue Date
2010-10
Metadata
Show full item recordAbstract
The prognosis for advanced/inoperable biliary tract cancer is poor and the management of biliary obstruction and sepsis remains the cornerstone of best supportive care (BSC). Many phase II studies have reported some activity of chemotherapy, usually involving one or more of a fluoropyrimidine, a platinum agent and gemcitabine. No adequately powered study has shown conclusively a benefit for chemotherapy compared with BSC alone although three small randomized studies have suggested an improved survival. Results from the randomized phase III ABC-02 study demonstrated a survival advantage of cisplatin and gemcitabine doublet-chemotherapy over gemcitabine monotherapy {median survival of 11.7 compared with 8.1 months, hazard ratio (HR), 0.64 [95% confidence interval (CI) 0.52 to 0.80]; log rank P < 0.001} as well as a significantly longer progression-free survival [median 8 compared with 5 months; HR 0.63 (95% CI 0.51 to 0.77); log rank P < 0.001]. A similar magnitude of benefit was seen in Japanese patients in a second study using the same treatment regimens (the BT-22 study). Ongoing studies are underway evaluating other chemotherapy regimens in first-line although attention is turning to the addition of targeted therapies; these will be reviewed. Pivotal to success in this process is both the identification of appropriate targets across this heterogeneous group of malignancies (e.g. EGFR, VEGF, MEK inhibition, amongst others) and collaboration between investigators to deliver relevant, timely and adequately powered studies.Citation
Advances in the treatment of metastatic or unresectable biliary tract cancer. 2010, 21 Suppl 7:vii345-vii348 Ann OncolJournal
Annals of OncologyDOI
10.1093/annonc/mdq420PubMed ID
20943640Type
ArticleLanguage
enISSN
1569-8041ae974a485f413a2113503eed53cd6c53
10.1093/annonc/mdq420
Scopus Count
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