P-139 - Efficacy of a Sequential Treatment Strategy with GEMOX Followed by FOLFIRI in Advanced Cholangiocarcinoma

Date 04 July 2015
Event WorldGI 2015
Session Posters
Topics Anti-Cancer Agents & Biologic Therapy
Hepatobiliary Cancers
Presenter S. Faivre
Citation Annals of Oncology (2015) 26 (suppl_4): 1-100. 10.1093/annonc/mdv233
Authors S. Faivre1, P. Hammel2, A. De Gramont3, E. Raymond1, S. Sebbagh1, J. Roux1, C. Dreyer1, C. Neuzillet4, C. Orbegoso5, O. Hentic2, T. André6, B. Chibaudel7
  • 1Beaujon Hospital, Clichy/FR
  • 2Hôpital Beaujon, Clichy/FR
  • 3CHUV, Lausanne/CH
  • 4Hôpital Henri-Mondor, Créteil/FR
  • 5Marques de Valdecilla University Hospital, Santander/ES
  • 6Hopital Saint-Antoine, Paris/FR
  • 7Institut Franco-Britannique, Levallois-Perret/FR



Gemcitabine (GEM)-platinum chemotherapy is validated first-line strategy for patients with recurrent/advanced cholangiocarcinoma (CK), with progression-free survival (PFS) of 6-8 months. No standard second-line chemotherapy after GEM-platinum failure exists and data on survival benefit remain limited.


We retrospectively reviewed patients with recurrent/advanced CK who received the GEM-oxaliplatin combination (GEMOX) followed by 5-fluorouracil combined with irinotecan (FOLFIRI) to evaluate the efficacy of the sequential treatment strategy. Overall survival (OS) and PFS were calculated by Kaplan-Meier method.


Fifty-two patients were analyzed, 21 (40%) had intrahepatic CK, 14 (27%) had hilar/extrahepatic CK, and 17 (33%) had gallbladder cancer. Median age was 64 years (range: 38-79 year). Prior to GEMOX, 49 (94%) and 3 (6%) patients were performance status (PS) 0-1 and PS 2, respectively; and before FOLFIRI, 14 (27%) patients were PS 2-3. Prior curative-intent resection of the primary tumor was performed in 23 (44.2%) patients and 12 (23.1%) patients received GEMOX adjuvant chemotherapy. After a median follow-up of 36.3 months, 47 (90.4%) patients completed the treatment strategy. First-sequence GEMOX and second-sequence FOLFIRI achieved 4.8 months and 3.2 months median PFS, respectively. The global OS for the sequential chemotherapy was 21.9 months. The sequence of FOLFIRI resulted in a median OS of 8.4 months.


The sequence of GEMOX-FOLFIRI is a potential treatment strategy for patients with recurrent/advanced CK. However, only a modest impact on OS was observed. Further studies with novel therapeutic agents to improve survival in CK patients are required.