Abstract 2324
Background
Combined HCC-CCA is rare malignancy with incidence of less than 5% of primary hepatic malignancies. Because combined HCC-CCA has been excluded in clinical trials for either HCC or CCA, optimal systemic chemotherapy regimen has not been defined yet for combined HCC-CCA. Therefore, we analyzed efficacy of systemic chemotherapy in patients with unresectable or metastatic combined HCC-CCA.
Methods
Among patients with histologically confirmed combined HCC-CCA from 1999 to 2015 in Asan Medical Center, Seoul, Korea, 120 patients who received systemic chemotherapy for unresectable or metastatic disease were identified and included in this analysis. Overall response rate (ORR), progression-free survival (PFS), and overall survival (OS) were retrospectively evaluated.
Results
15 patients had initially metastatic disease and the other 105 patients had recurrent or progressive disease after local therapy. Sorafenib (n = 69, 56.7%), gemcitabine plus cisplatin (GP) (n = 21, 17.5%), 5-FU-based chemotherapy (n = 22, 19.2%) were most frequently used regimens. Overall, ORR was 10.8%, and median PFS and OS was 4.2 (95% CI 3.0-5.5) and 9.0 months (7.0-11.1), respectively with median follow-up of 39.6 months (24.8-54.3). ORR, PFS and OS did not differ according to chemotherapy regimens (ORR, 7.2%, 13.7% and 18.2%, p = 0.30; median PFS, 4.6 [95% CI 3.8-5.4], 3.7 [1.8-5.6] and 7.9 months [0.5-15.2], p = 0.67; and median OS, 9.8 [7.5-12.1], 8.8 [6.8-10.8], and 8.8 months [4.9-12.7], p = 0.62 in patients with sorafenib, GP, and 5-FU-based chemotherapy, respectively). In univariate analysis, elevated baseline carcinoembryonic antigen (CEA) level, liver cirrhosis (LC) and large tumor burden (≥30% of liver volume) were significantly associated with poorer OS, and these remained significant in multivariate analysis (HR 2.29, 95% CI, 1.26-4.14, p = 0.006 for elevated CEA level; HR 1.67, 1.03-2.70, p = 0.04 for LC; HR 4.75, 2.22-10.16, p < 0.001 for large tumour burden).
Conclusions
Patients with advanced HCC-CCA treated with systemic chemotherapy showed poor prognosis. Further clinical trials to understand biology of combined HCC-CCA and find optimal systemic agents are needed.
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
3392 - Post-hoc analysis of the nintedanib exposure-response relationships in the CHIVA trial in advanced ovarian cancer: (a GINECO study)
Presenter: Skerdi HAVIARI
Session: Poster Display session 2
Resources:
Abstract
714 - The feasibility and efficacy of gonadotropin-releasing hormone agonists for prevention of chemotherapy-induced ovarian insufficiency in patient with malignant ovarian germ cell tumors
Presenter: Min Kyu Kim
Session: Poster Display session 2
Resources:
Abstract
1753 - Ex vivo cytotoxicity and in vivo antitumor activity of a novel highly selective STAT3 inhibitor YHO-1701 for ovarian and endometrial cancer
Presenter: Kosei Hasegawa
Session: Poster Display session 2
Resources:
Abstract
3739 - Mutational landscapes and tumor mutational burden expression in endometrial cancer
Presenter: Yingli Zhang
Session: Poster Display session 2
Resources:
Abstract
2109 - Clinical features and frequency of mismatch repair protein deficiency in ovarian clear cell and endometrioid carcinoma patients.
Presenter: Kazuhiro Takehara
Session: Poster Display session 2
Resources:
Abstract
4554 - Prospective study evaluating white adipose tissue inflammation and clinicopathologic features in endometrial cancer
Presenter: Lea Moukarzel
Session: Poster Display session 2
Resources:
Abstract
3645 - Cancer-specific survival with or without adjuvant chemotherapy in high-risk stage I endometrial cancer
Presenter: Jenny Ko
Session: Poster Display session 2
Resources:
Abstract
3394 - Pembrolizumab in Patients with MSI-H Advanced Endometrial Cancer from the KEYNOTE-158 Study
Presenter: David Omalley
Session: Poster Display session 2
Resources:
Abstract
3388 - Who drops out of cervical cancer screening? Results from the EDIFICE 6 survey
Presenter: Thibault de La Motte Rouge
Session: Poster Display session 2
Resources:
Abstract
2485 - Identification of a RNA-Seq Based Signature to Improve Prognostic for Uterine Sarcoma
Presenter: Jian-Guo Zhou
Session: Poster Display session 2
Resources:
Abstract