Abstract 3879
Background
Most of iCCA patients die because of hepatic progression, even in metastatic stage. Chemotherapy leads to modest increase in life expectancy; arterial-directed therapies (ADT), such as chemoembolization (TACE) or radioembolization (TARE), have been proposed to obtain local disease control, eventually leading to a survival benefit.
Methods
We conducted a multicenter retrospective study involving 8 Italian Cancer Centers to evaluate efficacy outcomes and safety of ADT in advanced iCCA. Primary endpoint was overall survival (OS) from the first ADT.
Results
99 patients received at least one ADT from 2007 to 2017. TACE was performed in 74 patients, TARE in 25 patients. Median time from diagnosis of advanced disease to first ADT was 7.0 months. Median OS from first ADT was 11.9 months (95% CI 9.9-16.1); progression-free survival was 3.4 months (95% CI 3.2-4.0) with a disease control rate of 64% and an objective response rate of 20%. Adverse events (AE) after procedure were reported in 37 patients, more commonly low grade (G1-G2) abdominal pain (19%) and fever (18%); G3-G4 AE were reported in 11% of patients, while one fatal (G5) AE occurred due to brain hemorrhage one week after the procedure. No survival differences were observed in patients receiving more than one ADT (n.47) compared to those receiving only one procedure (n.52). OS according to procedure (TARE or TACE) was 19.1 and 10.5 months respectively (HR 0.53; 95% CI 0.32-0.88; p.031). Extrahepatic disease and Ca19.9 levels >100 kU/L were significantly associated with worse OS at univariate analysis (HR 1.77 and 2.73, respectively).
Conclusions
Patients receiving ADT had good survival outcomes when compared with historical data of systemic chemotherapy, although authors acknowledge these data could also be driven by a selection bias. Procedures were feasible and tolerable, with limited serious AEs. Notably, patients receiving more than one procedure did not gain an OS benefit compared to those receiving only one ADT. According to these retrospective data, performing ADT in presence of extrahepatic disease may be questionable. Specific prospective studies should be designed in order to confirm ADT role in iCCA.
Clinical trial identification
Legal entity responsible for the study
Istituto Oncologico Veneto IRCCS.
Funding
Has not received any funding.
Editorial Acknowledgement
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
5720 - Evaluation of stemness and proliferation of human breast cancer stem cells (ALDH+) supplemented with heat-activated TGF-beta1 in the secretomes of stem cells from human exfoliated deciduous teeth (SHED)
Presenter: Septelia Wanandi
Session: Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology
Resources:
Abstract
4844 - Estrogen-related receptor _ as a potential molecular target for endometrial cancer therapy
Presenter: TETSUYA KOKABU
Session: Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology
Resources:
Abstract
1200 - Good tolerability and limited target-specific tissue distribution of an anti-L1CAM antibody administered to cynomolgus monkey indicates favorable safety profile of L1CAM-targeting therapies
Presenter: Jacques Gaudreault
Session: Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology
Resources:
Abstract
2905 - Pharmacokinetic drug-drug interaction between mitotane and etoposide in the treatment of adrenocortical carcinoma
Presenter: Anne Jouinot
Session: Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology
Resources:
Abstract
2597 - Real-world dosing of regorafenib (REG) in metastatic colorectal cancer (mCRC): final results from the prospective, observational CORRELATE study
Presenter: Juan Manuel O'Connor
Session: Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology
Resources:
Abstract
2663 - Safety and efficacy of trifluridine/tipiracil (FTD/TPI) in metastatic colorectal cancer (mCRC) patients according to previous treatment with regorafenib in the international phase 3b PRECONNECT study
Presenter: Julien Taieb
Session: Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology
Resources:
Abstract
1670 - Treatment pattern and outcomes of trifluridine/tipiracil therapy for metastatic colorectal cancer in the real-world data from the JFMC50 study
Presenter: Takeshi Kawakami
Session: Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology
Resources:
Abstract
1088 - Phase II trial to evaluate efficacy and tolerance of regorafenib monotherapy in patients (pts) over 70 with previously treated metastatic colorectal adenocarcinoma (mCRC) FFCD 1404 - REGOLD
Presenter: thomas Aparicio
Session: Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology
Resources:
Abstract
2548 - Prospective Evaluation of Regorafenib Dose Escalation Strategy with Low Starting Dose in Patients with Colorectal Cancer
Presenter: Toshiki Masuishi
Session: Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology
Resources:
Abstract
3244 - Regorafenib for metastatic colorectal carcinoma: a registry-based analysis
Presenter: Katerina Kopeckova
Session: Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology
Resources:
Abstract