Targeted therapy for biliary-tract cancer

Furuse, Junji

doi:10.1016/s1470-2045(09)70370-5

Cited by 4 publications

(3 citation statements)

References 40 publications

(45 reference statements)

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“…It is unclear whether combined treatment with molecular targeted agents or other cytotoxic chemotherapeutic agents may also be effective against BTC [26,27]. Although incorporation of targeted therapy with gemcitabine plus platinum may improve outcomes, erlotinib did not improve progression-free survival in a randomized phase 3 trial of patients with metastatic BTC [10].…”

Section: Discussionmentioning

confidence: 99%

Gemcitabine plus Cisplatin versus Capecitabine plus Cisplatin as First-Line Chemotherapy for Advanced Biliary Tract Cancer: A Retrospective Cohort Study

Woo¹,

Lee²,

Kim³

et al. 2013

Chemotherapy

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Background and Aim: Gemcitabine plus cisplatin (GP) is a standard chemotherapy option for patients with advanced biliary tract cancer (BTC). We compared the efficacy and safety of capecitabine plus cisplatin (XP) versus GP in advanced BTC. Methods: The records of all patients treated with GP or XP chemotherapy for unresectable, metastatic, or recurrent BTC at the National Cancer Center between December 2001 and August 2012 were reviewed retrospectively. Patients with histologically confirmed intrahepatic cholangiocarcinoma, gallbladder cancer, or extrahepatic cholangiocarcinoma were enrolled. Results: Of the 344 patients enrolled, 127 received GP and 217 received XP. At a median follow-up time of 8.9 months, the median time to progression was longer in the GP group than in the XP group (5.6 vs. 4.7 months), but the difference was not statistically significant (p = 0.081). The median overall survival (OS) was 8.4 months (95% CI 6.2-10.7) in the GP group and 7.6 months (95% CI 6.8-8.7) in the XP group (p = 0.024), with statistical significance retained following multivariate analysis (HR 0.72; 95% CI 0.527-0.987; p = 0.004). Grade 3/4 toxicities were significantly more frequent in the GP group than in the XP group (40.9 vs. 24.9%, p = 0.002). Conclusions: GP was superior to XP in prolonging OS, despite increasing the rate of grade 3/4 adverse events.

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Section: Discussionmentioning

confidence: 99%

Gemcitabine plus Cisplatin versus Capecitabine plus Cisplatin as First-Line Chemotherapy for Advanced Biliary Tract Cancer: A Retrospective Cohort Study

Woo¹,

Lee²,

Kim³

et al. 2013

Chemotherapy

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“…These targeted therapies offer hope of improved survival in patients with BTC 20‐24 . As monotherapy they have minor effect, but in combination with systemic chemotherapy, they have both shown to have synergistic effect 3,25 …”

Section: Introductionmentioning

confidence: 99%

“…[20][21][22][23][24] As monotherapy they have minor effect, but in combination with systemic chemotherapy, they have both shown to have synergistic effect. 3,25 Our aim was to investigate whether panitumumab or bevacizumab in combination with chemotherapy should proceed to further clinical development. We designed a randomized cross-over Phase II screening trial primarily to compare the rate of PFS at 6 months and secondarily to compare other endpoints as signals of clinical effect.…”

mentioning

confidence: 99%

Randomized Phase II trial of combination chemotherapy with panitumumab or bevacizumab for patients with inoperable biliary tract cancer without KRAS exon 2 mutations

Amin

Hansen

Fernebro

et al. 2021

Intl Journal of Cancer

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Biliary tract cancers (BTC) are rare and often diagnosed in late stages with advanced, nonresectable disease. The targeted agents panitumumab and bevacizumab have shown promising outcomes in combination with chemotherapy in other gastrointestinal (GI) cancers. We wanted to investigate if panitumumab or bevacizumab was the most promising drug to add to chemotherapy. Eighty‐eight patients were randomized to combination chemotherapy supplemented by either panitumumab 6 mg/kg or bevacizumab 10 mg/kg on Day 1 in Arm A and Arm B, respectively. All patients received gemcitabine 1000 mg/m2 on Day 1, oxaliplatin 60 mg/m2 on Day 1 and capecitabine 1000 mg/m2 twice daily from Days 1 to 7. Treatment was repeated every 2 weeks until progression or for a maximum of 6 months. At progression, crossover was made to the other treatment arm. The primary endpoint was progression‐free survival (PFS) at 6 months. With 19 of 45 in Arm A and 23 of 43 in Arm B PFS at 6 months, the primary endpoint was not met. The overall response rate (ORR) was 45% vs 20% (P = .03), median PFS was 6.1 months vs 8.2 months (P = .13) and median overall survival (OS) was 9.5 months vs 12.3 months (P = .47) in Arm A and Arm B, respectively. Our study showed no consistent differences between adding panitumumab or bevacizumab to chemotherapy in nonresectable BTC and none of the two regimens qualify for testing in Phase III. However, we found a higher response rate in the panitumumab arm with potential implication for future trials in the neoadjuvant setting.

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Systematic review with network meta‐analysis: adjuvant therapy for resected biliary tract cancer

Zhu

Shi

You

et al. 2014

Aliment Pharmacol Ther

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Summary Background Major adjuvant therapies for biliary tract cancer (BTC) include fluorouracil, gemcitabine and chemoradiation (CRT), but the optimum regimen remains inconclusive. Aim To compare these therapies in terms of patient survival rates after resection and toxic effects. Methods We searched PubMed for controlled trials comparing the above three therapies with each other or observation alone until 31 January 2014. We estimated the hazard ratios (HRs) for death and odds ratios (ORs) for toxic effects among different therapies. Subgroup analyses based on positive lymph node or resection margin were also performed. Results Twelve eligible articles were included. Gemcitabine improved 5‐year survival (HR 2.12, 95% CI, confidence interval 1.23–4.02, P = 0.01), whereas fluorouracil (HR 1.61, 95% CI 0.74–3.67) and CRT (HR 1.55, 95% CI 0.82–3.32) provided a poorer survival outcome compared with gemcitabine after 1 year. Similarly, for 5‐year survival rates, although differing, CRT did not provide a significant improvement in survival (HR 0.46, 95% CI 0.20–0.97) compared with gemcitabine. Fluorouracil did not appear to provide benefit over gemcitabine (HR 1.56, 95% CI 0.77–3.35). CRT was ranked highest for toxic effects including haematological (OR 5.45, 95% CI 0.01–483.85) and nonhaematological (OR 5.77, 95% CI 0.01–3807.40). Conclusions Chemotherapy with gemcitabine is the optimum adjuvant treatment with a balanced benefit‐toxicity ratio for resected biliary tract cancer. Chemoradiation was more likely to cause toxic effects.

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Targeted therapy for biliary-tract cancer

Cited by 4 publications

References 40 publications

Gemcitabine plus Cisplatin versus Capecitabine plus Cisplatin as First-Line Chemotherapy for Advanced Biliary Tract Cancer: A Retrospective Cohort Study

Gemcitabine plus Cisplatin versus Capecitabine plus Cisplatin as First-Line Chemotherapy for Advanced Biliary Tract Cancer: A Retrospective Cohort Study

Randomized Phase II trial of combination chemotherapy with panitumumab or bevacizumab for patients with inoperable biliary tract cancer without KRAS exon 2 mutations

Systematic review with network meta‐analysis: adjuvant therapy for resected biliary tract cancer

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