Abstract 1700
Background
Limited evidence is available regarding survival benefit of SLC in patients with ABGC. After failure of first-line treatment, currently no "standard" second-line therapy is available. There is a lack of randomized clinical trials and well-designed population-based study to address this important question in the management of ABGC. In this population-based cohort study we evaluated if SLC prolongs survival in patients with ABGC.
Methods
Patients with biopsy proven ABGC who were diagnosed in the province of Saskatchewan during the period of 2006 to 2015 and received first-line chemotherapy were assessed. Based on the use of SLC, patients were divided into ‘Treatment’ group or ‘Control’. Cox proportional multivariate analyses were performed to determine survival benefit of SLC.
Results
136 eligible patients with median age of 66 (IQR, 55-73) and M:F of 1:1.34 were identified. Primary tumor sites were as followed: gallbladder 31%, intrahepatic cholangiocarcinoma 36%, bile duct 23%, and ampullary 10%. 68% patients had metastatic disease.37% patients received SLC and of those 42% received combination therapy. There were significant differences between the two groups with respect to age and baseline liver function. The median overall survival (mOS) of treatment group was 17 months (95%CI, 12.5-21.5) vs. 7 months (5.3-8.7) of control (p < 0.0001). Patients who received combination SLC had mOS of 20 months (14.0-26.1) vs. 17 (13.5-20.5) with single agent chemotherapy (p = 0.73). On progression 36% received 3rd or subsequent line treatment. On univariate analysis SLC HR 0.51 (0.35-0.73), bilirubin 0.52 (0.34-0.79), and neutrophil to lymphocyte ratio (NLR) 1.11 (1.07-1.16) significantly correlated with survival. Test for interaction between SLC and all the other variables were not significant. On multivariate analysis SLC HR 0.55 (0.36-0.83) and NLR 1.10 (1.05-1.15) were significantly correlated with survival.
Conclusions
This well-designed population based cohort study suggests a substantial survival benefit associated with SLC. Patients with ABGC who are potential candidate for chemotherapy should be offered active treatment or participation in the clinical trial.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Saskatchewan Cancer Agency Research Grant.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
3330 - Tumour-infiltrating lymphocytes and BRCA-like status in stage III breast cancer patients treated with intensified carboplatin-based chemotherapy
Presenter: Leonora De Boo
Session: Poster Display session 2
Resources:
Abstract
3971 - Unravelling the biological characteristics of MammaPrint extreme risk subgroups
Presenter: Rajith Bhaskaran
Session: Poster Display session 2
Resources:
Abstract
5871 - Residual Cancer burden as a prognostic factor in a large series of Neoadjuvant chemotherapy. Subgroup analysis per molecular surrogated subtypes
Presenter: Catalina Falo
Session: Poster Display session 2
Resources:
Abstract
5014 - Clinical validation of CanAssist Breast in a Spanish cohort
Presenter: Manjiri Bakre
Session: Poster Display session 2
Resources:
Abstract
2787 - Meta-analysis on association of pathological complete response with long-term survival outcomes in triple-negative breast cancer
Presenter: Peter A. Fasching
Session: Poster Display session 2
Resources:
Abstract
4301 - Immune infiltrate composition across intrinsic subtypes in hormone receptor (HR)+/HER2- early breast cancer (BC) enrolled in the prospective LETLOB trial
Presenter: Gaia Griguolo
Session: Poster Display session 2
Resources:
Abstract
3205 - Frequency of germline mutations in women's cancer susceptibility genes in a large cohort of Chinese breast cancer patients
Presenter: Ning Liao
Session: Poster Display session 2
Resources:
Abstract
4091 - Triple blinded Prospective Study assessing the Impact of Genomics & Artificial Intelligence Watson For Oncology (WFO) on MDT’s Decision of Adjuvant Systemic Therapy for Hormone Receptor Positive Early Breast Carcinoma-
Presenter: Somashekhar Sampige Prasannakumar
Session: Poster Display session 2
Resources:
Abstract
4359 - Prognostic significance of Progesterone Receptor levels in luminal-like Her2- early Breast Cancer patients. A retrospective single Cancer Center analysis.
Presenter: Anna Diana
Session: Poster Display session 2
Resources:
Abstract
1369 - PAM50 HER2-enriched subtype and pathological complete response in HER2-positive early breast cancer: a meta-analysis
Presenter: Francesco Schettini
Session: Poster Display session 2
Resources:
Abstract