731P - Second-line therapy in advanced biliary tract cancer: baseline data from a retrospective multi-centre series

Date 30 September 2012
Event ESMO Congress 2012
Session Poster presentation II
Topics Anti-Cancer Agents & Biologic Therapy
Hepatobiliary Cancers
Presenter John Bridgewater
Authors J.A. Bridgewater1, D. Palmer2, D. Cunningham3, T. Iveson4, R. Gillmore5, J. Waters6, M. Harrison7, H. Wasan8, J.W. Valle9, P. Corrie10
  • 1UCL Cancer Institute, University College London, UK WC1E 6DD - LONDON/UK
  • 2Liverpool Cancer Research Uk Centre, University of Liverpool, Liverpool/UK
  • 3The Royal Marsden, The Royal Marsden, London/UK
  • 4Medical Oncology, Southampton General Hospital, Southampton/UK
  • 5Oncology, Royal Free Hospital, London/UK
  • 6Oncology, Kent Oncology Centre, Medway/UK
  • 7Cancer Centre, Mount Vernon Cancer Centre, London/UK
  • 8Hammersmith Hospital, Department of Oncology, London/UK
  • 9Medical Oncology, The Christie NHS Foundation Trust, GB-M20 4BX - Manchester/UK
  • 10Oncology Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge/UK

Abstract

Background

Effective first-line treatment for patients with advanced biliary tract cancer (BTC) has been established with a median survival of approaching 12 months (NEJM 2010; 362:1273). No second line regimen is established although small retrospective series suggest that chemotherapy may be active in selected patients. We present results of a large retrospective series of patients undergoing second-line chemotherapy at institutions across the UK that use the ABC-02 standard of Cisplatin and Gemcitabine (CisGem) as first-line treatment.

Methods

Patients with ABC, previously treated with CisGem and who went on to receive second-line chemotherapy, were identified from institutional databases. Demographic data, response and survival outcome measures were collected according to an agreed proforma.

Results

Sixty-three eligible patients (median age: 61.6 years (range: 39.8 – 78.3 years)) were identified between Feb 2007 and Feb 2011, from 9 centres. Patients were treated mostly with a platinum based regimen (n = 42), either a re-challenge of CisGem (n = 17), an oxaliplatin/ infused 5-FU regimen (mFOLFOX, n = 17) or oxaliplatin with capecitabine (n = 4). Most patients had a performance status of 0 or 1. A median PFS of 4.0 months (95% CI: 3.3 – 5.6 months) and an OS of 8.1 months (95% CI: 5.3 – 11.4 months) following second line therapy were demonstrated. Patients had an overall OS of 19.5 months (95% CI: 17.0 – 25.2 months) from the start of first-line therapy; this compares with a median OS of 11.7 months from the ABC-02 study.

Conclusions

Use of second-line chemotherapy in advanced BTC is of potential benefit. These data, although retrospective, suggests there is a population suitable for second-line, prospective randomised studies with chemotherapy or targeted agents and provide baseline outcome data with which to statistically design such studies. Updated data will be shown.

Disclosure

All authors have declared no conflicts of interest.