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 Anticancer agents
Hepatobiliary Cancers
Biological therapy
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.