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
1452 - RBP-Jκ in colon cancer cells facilitates tumor associated macrophages (TAMs)-induced cell metastasis by secreting CXCL11
Presenter: Meng jie Liu
Session: Poster Display session 2
Resources:
Abstract
2786 - Development of a living organoid biobank derived from colorectal cancer patients: towards personalized medicine
Presenter: Federica Papaccio
Session: Poster Display session 2
Resources:
Abstract
3351 - Microsatellite Instability Detection in Colorectal Cancer: 44-Center Comparison between the Idylla MSI Assay and Routine Molecular and Immunohistochemistry Tests on Formalin-Fixed Paraffin-Embedded Tissue
Presenter: Xavier Matias-guiu
Session: Poster Display session 2
Resources:
Abstract
4901 - Expression profile of EPHB3 and its prognostic significance in colorectal cancer progression (Running head: Prognostic value of EPHB3 in colorectal cancers)
Presenter: Bogun Jang
Session: Poster Display session 2
Resources:
Abstract
5030 - A pan-ErbB family inhibitor, AF8c, promotes apoptosis by DR5/Nrf2 activation via ROS in colorectal cancer cells
Presenter: Soyeon Jeong
Session: Poster Display session 2
Resources:
Abstract
5053 - Frequent BRAF, GNAS and SMAD4 mutations identified in Colorectal Mucinous Carcinomas
Presenter: Sun Mi Lee
Session: Poster Display session 2
Resources:
Abstract
5220 - Impact of CCL4 knockout using CRISPR Cas-9 technology on colorectal tumor progression
Presenter: Roba Barakat
Session: Poster Display session 2
Resources:
Abstract
5330 - Independent clinical validation of a gene expression profile to predict benefit of 5-FU in metastatic colorectal cancer
Presenter: Ida Buhl
Session: Poster Display session 2
Resources:
Abstract
5515 - WRN mutated Colorectal Cancer (CRC) is characterized by a distinct molecular and immunological profile
Presenter: Andreas Seeber
Session: Poster Display session 2
Resources:
Abstract
5716 - Mutation analysis of B2M gene in colorectal cancer patients with microsatellite instability
Presenter: Ivana Kašubová
Session: Poster Display session 2
Resources:
Abstract