FOLFIRINOX as a first-line chemotherapy for patients (pts) with advanced biliary tract cancer (BTC)

Ulusakarya, Ayhan; Karray, W.; Abdou, Jiddou; Karaboué, Abdoulaye; Haydar, Mazen; Krimi, Sarra; Gümüş, Yusuf Yasin; Almohamad, Wathek; Goldschmidt, Emma; Biondani, Pamela; Morère, J. F.

doi:10.1093/annonc/mdy282.144

Cited by 4 publications

(3 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…15 , 24 In the first-line, three retrospective studies evaluated FOLFIRINOX in advanced BTC and found a median PFS of 6.0–9.0 months, median OS of 10.0–15.0 months and an ORR of 36%–50%. 16 , 17 , 25 The difference in ORR between these retrospective studies and our study could be partly explained by the fact that more responses are observed in first-line than in the second-line. Moreover, previous studies have shown that it is difficult to adequately asses the objective response in advanced BTC because the tumours are not well demarcated and show infiltration of the surrounding tissue.…”

Section: Discussioncontrasting

confidence: 75%

Efficacy and safety of FOLFIRINOX as salvage treatment in advanced biliary tract cancer: an open-label, single arm, phase 2 trial

et al. 2020

View full text Add to dashboard Cite

Background No standard treatment is available for advanced biliary tract cancer (BTC) after first-line therapy with gemcitabine plus cisplatin (GEMCIS). The objective of this study was to evaluate safety and anti-tumour activity of fluorouracil, leucovorin, irinotecan plus oxaliplatin (FOLFIRINOX) as salvage treatment in patients with previously treated advanced BTC. Methods In this two-stage phase 2 study, patients with advanced BTC who had disease progression or unacceptable toxicity after ≥3 cycles of GEMCIS were eligible. Primary endpoints were safety and efficacy (defined as objective response rate, ORR). In stage one, ten patients were treated with FOLFIRINOX every 2 weeks. In stage two, an additional 20 patients were enrolled at a starting dose as defined in stage one, provided that in stage ≥1 objective response or ≥2 stable diseases were observed and ≤3 patients had serious adverse events (SAEs) within the first 6 weeks of treatment. Secondary endpoints were progression-free survival (PFS) and overall survival (OS). Results Forty patients were screened for eligibility and 30 patients were enrolled. In stage one, one patient had a partial response and five patients had stable disease. One patient had a SAE during the first 6 weeks of treatment, and five patients required a dose reduction due to adverse events. The most common grade 3–4 adverse events in stage one were neutropaenia, mucositis and diarrhoea. Stage two was initiated with FOLFIRINOX in an adapted dose. In stage two, grade 3–4 neutropaenia, diarrhoea, nausea and vomiting were the most common adverse events. The ORR, median PFS and OS in all patients were 10%, 6.2 and 10.7 months, respectively. Conclusions In patients with advanced BTC who progressed after or were intolerant to GEMCIS, FOLFIRINOX can be administered safely and could be considered as an option for salvage treatment in these patients. Clinical trial registration ClinicalTrials.gov Identifier NCT02456714.

show abstract

Section: Discussioncontrasting

confidence: 75%

Efficacy and safety of FOLFIRINOX as salvage treatment in advanced biliary tract cancer: an open-label, single arm, phase 2 trial

et al. 2020

View full text Add to dashboard Cite

show abstract

“…The superiority of the combination regimen of folinic acid, fluoropyrimidine, irinotecan, and oxaliplatin (FOLFIRINOX) over Gem in pancreatic cancer patients [26] has led to the rationale for using this regimen in BTC patients. In a small retrospective series, FOLFIRINOX, as first-line treatment for BTC, has led to a disease control rate of 75% and OS of 15 months [27,28]. The ongoing Phase II/III PRODIGE38-AMEBICA trial (NCT02591030) aims to demonstrate an improvement in OS of 4 months in favour of the modified FOLFIRINOX (no 5-FU bolus on day 1) vs. GemCis [29].…”

Section: Advanced Disease: First-line Treatmentmentioning

confidence: 99%

Biliary Tract Cancer: Current Medical Treatment Strategies

Oneda

Hilal

Zaniboni

2020

Cancers

View full text Add to dashboard Cite

Background: Biliary tract cancers (BTCs) include cholangiocarcinomas and gallbladder cancers usually present at an advanced stage, which are considered resectable in less than 20% of cases and characterised by poor prognosis. Methods: In this review, we discussed the most recent therapeutic options on the basis of the most updated and complete reviews and recent prospective studies in selected BTC patients. Results: Due to the high recurrence rate of BTCs, we suggest the new recommendations that have been made on adjuvant chemotherapy and radiotherapy treatment after surgery. New chemotherapy combinations in advanced-stage patients allow a better survival benefit than the standard treatment. Furthermore, the revelation of complex molecular events and their interactions and relationships with some risk factors allowed the development of targeted/toxic agents alone or combination with chemotherapy that is really promising. In unresectable patients, hepatic arterial infusion of high-dose chemotherapy or selective internal radiotherapy could offer a primary mass volume reduction or its resection with the maintenance of liver function. Conclusions: The therapeutic landscape for BTCs is blooming again, the knowledge of their biology is still growing, but the available data on chemotherapy, radiotherapy, locoregional treatments, and target therapies have added hopes to improve patient survival.

show abstract

“…However, in most cases, these were unselected populations and results were either negative or not convincing enough to alter clinical practice. A retrospective analysis of 42 patients with advanced BTCs treated with FOLFIRINOX chemotherapy in the first line suggested that the triplet regimen was efficacious without increased toxicity [35]. The prospective phase II/III AMEBICA study will investigate whether intensification of chemotherapy with FOLFIRINOX will further improve outcomes compared to gemcitabine/cisplatin in the first line advanced setting [36] (Table 3).…”

Section: Systemic Treatment Of Advanced Diseasementioning

confidence: 99%

Contemporary Tailored Oncology Treatment of Biliary Tract Cancers

Turkes

Carmichael

Cunningham

et al. 2019

Gastroenterology Research and Practice

View full text Add to dashboard Cite

Biliary tract cancers (BTCs) are poor prognosis malignancies with limited treatment options. Capecitabine has recently emerged as an effective agent in the adjuvant setting; however, treatment of advanced disease is still limited to first-line cisplatin and gemcitabine chemotherapy. Recent global efforts in genomic profiling and molecular subtyping of BTCs have uncovered a wealth of genomic aberrations which may carry prognostic significance and/or predict response to treatment, and several targeted agents have shown promising results in clinical trials. As such, the uptake of comprehensive genomic profiling for patients with BTCs and the expansion of basket trials to include these patients are growing. This review describes the currently approved systemic therapies for BTCs and provides insight into the emerging targeted and immunotherapeutic agents, as well as conventional chemotherapeutic regimes, currently being investigated in clinical trials.

show abstract

FOLFIRINOX as a first-line chemotherapy for patients (pts) with advanced biliary tract cancer (BTC)

Cited by 4 publications

References 0 publications

Efficacy and safety of FOLFIRINOX as salvage treatment in advanced biliary tract cancer: an open-label, single arm, phase 2 trial

Efficacy and safety of FOLFIRINOX as salvage treatment in advanced biliary tract cancer: an open-label, single arm, phase 2 trial

Biliary Tract Cancer: Current Medical Treatment Strategies

Contemporary Tailored Oncology Treatment of Biliary Tract Cancers

Contact Info

Product

Resources

About