Hepatic Arterial Infusion of Gemcitabine plus Oxaliplatin as Second-Line Treatment for Locally Advanced Intrahepatic Cholangiocarcinoma: Preliminary Experience

Ghiringhelli, François; Lorgis, Véronique; Vincent, Julie; Ladoire, Sylvain; Guiu, Boris

doi:10.1159/000362223

Cited by 31 publications

(17 citation statements)

References 52 publications

(34 reference statements)

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“…Considerable interest has been paid to various treatment options against ICC recurrence such as surgical treatment,6, 7, 8 chemotherapy,9 radiation therapy,7 radiofrequency ablation (RFA),10, 11 and transarterial chemotherapy 12, 13 with various degrees of success. In recent reports, aggressive surgical treatment for ICC recurrence led to good patient survival after recurrence, with a 3‐year overall survival (OS) rate of 25%,14 40%,6 and 100% 7.…”

Section: Introductionmentioning

confidence: 99%

Surgical management of recurrent intrahepatic cholangiocarcinoma: predictors, adjuvant chemotherapy, and surgical therapy for recurrence: A multi‐institutional study by the Kyushu Study Group of Liver Surgery

Yamashita

Shirabe²,

Beppu³

et al. 2017

Annals of Gastroent Surgery

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Objectives of the present study were to identify predictors of the recurrence of intrahepatic cholangiocarcinoma (ICC), and to evaluate the survival benefit of adjuvant chemotherapy and surgical treatment for ICC recurrence. A multi‐institutional retrospective study was carried out in 356 patients with ICC who underwent curative surgery at one of 14 institutions belonging to the Kyushu Study Group of Liver Surgery. A total of 214 patients (60%) had recurrence. Predictors of ICC recurrence were as follows: positive for pathological intrahepatic metastasis (im), positive for lymph node metastasis (n), positive for pathological lymphatic infiltration (ly), pathological bile duct invasion (b), and tumor size ≥4.4 cm. Adjuvant chemotherapy was given to 120 patients (34%) and, in the patients with im or tumor size ≥4.4 cm, adjuvant chemotherapy showed a survival benefit. Only 37 patients (17%) underwent surgical treatment for ICC recurrence. The surgical treatment resulted in a good 5‐year survival rate (44%), which is similar to the rate obtained by the first operation for primary ICC. Prognosis of patients with primary im after the second operation was significantly worse (5‐year survival 18%) compared to patients without primary im. Primary im+ should be considered a contraindication for surgical treatment for ICC recurrence.

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Section: Introductionmentioning

confidence: 99%

Surgical management of recurrent intrahepatic cholangiocarcinoma: predictors, adjuvant chemotherapy, and surgical therapy for recurrence: A multi‐institutional study by the Kyushu Study Group of Liver Surgery

Yamashita

Shirabe²,

Beppu³

et al. 2017

Annals of Gastroent Surgery

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“…Partial response, stable disease, and progressive disease rates were 7.7 and 81.4%, 41.2 and 100% (only hepatocellular carcinoma, 61.1% for ICC), as well as 0 and 30.8%, respectively [23,24,25,28,29]. It is noteworthy that three original series on HAI for advanced ICC were not mentioned in the above-cited review [30,31,32]. In two of the studies with a total of 23 patients, repetitive HAI was performed with different regimens including gemcitabine, oxaliplatin, 5-FU, adriamycin, epirubicin, mitomycin C, and/or cisplatin [30,32].…”

Section: Locoregional Therapymentioning

confidence: 99%

“…It is noteworthy that three original series on HAI for advanced ICC were not mentioned in the above-cited review [30,31,32]. In two of the studies with a total of 23 patients, repetitive HAI was performed with different regimens including gemcitabine, oxaliplatin, 5-FU, adriamycin, epirubicin, mitomycin C, and/or cisplatin [30,32]. The tumor control rates were 91.0 and 82.0%, and the overall survival was 9.1 months (median) and 26.0 months (mean).…”

Section: Locoregional Therapymentioning

confidence: 99%

Locoregional Therapies of Cholangiocarcinoma

2016

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Background: Cholangiocarcinoma (CC) is the second most primary liver malignancy with increasing incidence in Western countries. Currently, surgical R0 resection is regarded as the only potentially curative treatment. The results of systemic chemotherapy and best supportive care (BSC) in patients with metastatic disease are often disappointing in regard to toxicity, oncologic efficacy, and overall survival. In current practice, the use of different locoregional therapies is increasingly more accepted. Methods: A review of the literature on locoregional therapies for intrahepatic cholangiocarcinoma (ICC) was undertaken. Results: There are no prospective randomized controlled trials. For localized ICC, either primary or recurrent, radiofrequency ablation (RFA) is by far the most commonly used thermal ablation modality. Thereby, a systematic review and meta-analysis reports major complication in 3.8% as well as 1-, 3-, and 5-year overall survival rates of 82, 47, and 24%, respectively. In selected patients (e.g. with a tumor diameter of ≤3 cm), oncologic efficacy and survival after RFA are comparable with surgical resection. For diffuse ICC, different transarterial therapies, either chemotherapy-based (hepatic artery infusion (HAI), transarterial chemoembolization (TACE)) or radiotherapy-based (transarterial radioembolization (TARE)), show extremely promising results. With regard to controlled trials (transarterial therapy versus systemic chemotherapy, BSC or no treatment), tumor control is virtually always better for transarterial therapies and very often accompanied by a dramatic survival benefit and improvement of quality of life. Of note, the latter is the case not only for patients without extrahepatic metastatic disease but also for those with liver-dominant extrahepatic metastatic disease. There are other locoregional therapies such as microwave ablation, irreversible electroporation, and chemosaturation; however, the current data support their use only in controlled trials or as last-line therapy. Conclusion: Dedicated locoregional therapies are commonly used for primary and recurrent ICC as well as liver-only and liver-dominant extrahepatic metastatic disease. Currently, the best evidence and most promising results are available for RFA, HAI, TACE, and TARE. In cohort studies, the overall survival rates are similar to those obtained with surgery or systemic therapies. Prospective randomized controlled trials are warranted to compare safety and efficacy between different surgical, interventional, and systemic therapies, as well as their combinations.

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“…This technique was first used in the treatment of colorectal cancers (CRC) and is currently used widely in the treatment of various cancers including gastric and pancreatic cancers (PC) and hepatocellular carcinoma (HCC) [8][9][10]. Recently, the efficacy of conversion therapy in patients with IHCC was verified using several studies, which indicated that adequate tumor downstaging was achieved by systemic or local treatment and patients could obtain a relatively satisfactory prognosis [11][12][13][14][15][16][17]. However, most of these studies are case reports or case series containing no more than 10 patients.…”

Section: Introductionmentioning

confidence: 99%

Conversion Therapy of Intrahepatic Cholangiocarcinoma Is Associated with Improved Prognosis and Verified by a Case of Patient-Derived Organoid

Wang

Yun

Guo

et al. 2021

Cancers

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This study was performed to determine the efficacy of conversion therapy in intrahepatic cholangiocarcinoma (IHCC) and explore the feasibility of cancer organoid to direct the conversion therapy of IHCC. Patient data were retrospectively reviewed in this study and cancer organoids were established using tissues obtained from two patients. A total of 42 patients with IHCC received conversion therapy, 9 of whom were downstaged successfully, and another 157 patients were initially resectable. Kaplan–Meier curves showed that the successfully downstaged patients had a significantly improved overall survival compared to those in whom downstaging was unsuccessful (p = 0.017), and had a similar overall survival to that of initially resectable patients (p = 0.965). The IHCC organoid was successfully established from one of two obtained tissues. Routine hematoxylin and eosin staining and immunohistological staining found the organoid retained the histopathological characteristics of the original tissues. Whole exome sequencing results indicated the IHCC organoid retained appropriately 87% of the variants in the original tissue. Gemcitabine and paclitaxel exhibited the strongest inhibitory effects on the cancer organoid as determined using drug screening tests, consistent with the levels of efficacy observed in the patient from whom it was derived. This study indicates that conversion therapy could improve the survival of patients with IHCC despite its low success rate, and it may be directed by cancer organoids though this is merely a proof of feasibility.

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Hepatic Arterial Infusion of Gemcitabine plus Oxaliplatin as Second-Line Treatment for Locally Advanced Intrahepatic Cholangiocarcinoma: Preliminary Experience

Cited by 31 publications

References 52 publications

Surgical management of recurrent intrahepatic cholangiocarcinoma: predictors, adjuvant chemotherapy, and surgical therapy for recurrence: A multi‐institutional study by the Kyushu Study Group of Liver Surgery

Surgical management of recurrent intrahepatic cholangiocarcinoma: predictors, adjuvant chemotherapy, and surgical therapy for recurrence: A multi‐institutional study by the Kyushu Study Group of Liver Surgery

Locoregional Therapies of Cholangiocarcinoma

Conversion Therapy of Intrahepatic Cholangiocarcinoma Is Associated with Improved Prognosis and Verified by a Case of Patient-Derived Organoid

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