Abstract 1982
Background
Inclusion of all patients (pts) with advanced biliary tract cancer (aBTC), irrespective of anatomic location, with assessment of overall survival (OS) in prospective trials, is debated. Additionally, outcome is typically described as estimated OS, but CS offers more relevant information once pts have survived for some time; this study assessed the impact of anatomic site of BTC origin and CS.
Methods
Pts enrolled into 15 prospective first-line aBTC clinical trials were included. OS was analysed using Cox proportional hazard regression; CS and 95% confidence intervals (CIs) were calculated.
Results
Overall, 1333 pts were included (Jan 97-Dec 13) with a median (med) age of 63 yrs (range 23-85); 46% male; 84% ECOG PS 0/1; 25% locally advanced (LA) stage, 72% metastatic (met), and 3% not reported (NR). Anatomic site of origin was gallbladder (GBC): 385 (29%), cholangiocarcinoma not specified (CCA-NS): 363 (27%), extrahepatic (EHC): 247 (19%), intrahepatic (IHC): 209 (16%), ampulla: 53 (4%) and 76 (6%) NR. Treatment was mono-chemotherapy: 310 (23%), cis/gem combination: 482 (36%), other combination: 520 (39%) and NR: 21 (2%). Med OS: 10.2 mths (95% CI 9.6-10.9). All sites, adjusted for treatment, had decreased risk of death vs GBC: EHC (p<.001), IHC (p<.002), CCA-NS (p<.003), ampulla (p=.003). This reduced risk vs GBC was maintained in those receiving cis/gem combination therapy in EHC (p<.001) and IHC (p<.001), but not in CCA-NS (p=.82) or ampulla (p=.96). Probabilities of surviving an additional yr given survival to 1 (n = 552), 2 (n = 170), 3 (n = 53), and 4 (n = 23) yrs post trial registration were 37%, 45%, 61%, and 63% respectively. For pts who survived 1 yr; those receiving combination therapy vs mono (p=.008), and those with IHC and CCA-NS vs GBC had better CS (both p<.05). Met stage vs LA was associated with shorter CS (p=.002) and ECOG PS and gender had no effect on CS (p>.05, p=.08 respectively).
Conclusions
Pts with GBC have worse OS compared to other anatomic BTC sites. Inclusion of other BTC subtypes, at least, in prospective aBTC clinical trials is justified. Conditional probabilities allow adjusted prognosis prediction for survivors with aBTC.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
2376 - Patient Reported Outcomes (PRO) in patients (pts) with HER2- advanced breast cancer (ABC) and a germline BRCA1/2 mutation (gBRCAm) receiving talazoparib (TALA) vs physician’s choice chemotherapy (PCT) in the EMBRACA trial: A focus on subgroups with/ without visceral disease
Presenter: Johannes Ettl
Session: Poster Display session 2
Resources:
Abstract
4874 - Complete Responses in Patients With 2nd-Line or Greater Metastatic Triple-Negative Breast Cancer (TNBC) Following First-in-Human Immunotherapy Combining NK and T Cell Activation with Off-the-Shelf High-Affinity CD16 NK Cell Line (haNK)
Presenter: Chaitali Nangia
Session: Poster Display session 2
Resources:
Abstract
4362 - Reproducibility and concordance of 4 clinically developed programmed death-ligand 1 (PD-L1) immunohistochemistry (IHC) assays in triple-negative breast cancer (TNBC)
Presenter: Aurelia Noske
Session: Poster Display session 2
Resources:
Abstract
4528 - Systemic Therapy in 2nd-Line Metastatic Triple Negative Breast Cancer (mTNBC): A Systematic Literature Review (SLR) and Meta-Analysis (MA) of Efficacy
Presenter: Peter Kaufman
Session: Poster Display session 2
Resources:
Abstract
4112 - Cisplatin given at three divided doses for three consecutive days in metastatic breast cancer: an alternative schedule for one full dose with comparable efficacy but less CINV and hypomagnesaemia
Presenter: Yang Chen
Session: Poster Display session 2
Resources:
Abstract
5699 - Patterns and predictors of first-line (1L) taxane use in US patients with metastatic triple-negative breast cancer (mTNBC)
Presenter: Joyce O’Shaughnessy
Session: Poster Display session 2
Resources:
Abstract
1931 - Maintenance Chemotherapy is effective in Patients with Metastatic Triple Negative Breast Cancer After First-line Platinum-based Chemotherapy
Presenter: Jian Zhang
Session: Poster Display session 2
Resources:
Abstract
4696 - Using the Patient-Reported Outcomes Measurement Information System (PROMIS) to investigate symptom burden enrichment in Stage IV patients at an academic center
Presenter: Madeline Matthys
Session: Poster Display session 2
Resources:
Abstract
4582 - Measures of functional status in adults aged ≥70 years with advanced breast cancer (ABC) receiving palbociclib (PAL) combination therapy in POLARIS
Presenter: Meghan Karuturi
Session: Poster Display session 2
Resources:
Abstract
3565 - Real-World 1-Year Survival Analysis of Patients with Metastatic Breast Cancer with Liver or Lung Metastasis Treated with Eribulin, Gemcitabine or Capecitabine
Presenter: Shayma Kazmi
Session: Poster Display session 2
Resources:
Abstract