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
2667 - The impact of late-line treatment on overall survival (OS) from the initiation of first-line chemotherapy (CT) for patients (pts) with metastatic colorectal cancer (mCRC).
Presenter: Takeshi Kawakami
Session: Poster Display session 2
Resources:
Abstract
3139 - Efficacy and safety of FOLFIRI/Aflibercept (FA) in elderly population with mCRC after failure of oxaliplatin-based chemotherapy.
Presenter: Nieves Martinez Lago
Session: Poster Display session 2
Resources:
Abstract
3446 - Fluoropyrimidine-induced cardiotoxicity in colorectal cancer patients: preliminary data from the prospective observational CHECKPOINT trial (NCT02665312)
Presenter: Pasquale Lombardi
Session: Poster Display session 2
Resources:
Abstract
3969 - Comparable survival outcome between Thai patients with sporadic young adult and adult onset colorectal cancer
Presenter: Kanjana Sukhokanjanachusak
Session: Poster Display session 2
Resources:
Abstract
4455 - Impact of primary tumor side on 3-year survival outcomes of first-line (1L) FOLFOX-4 ± cetuximab in patients with RAS wild-type (wt) metastatic colorectal cancer (mCRC) in the phase 3 TAILOR trial
Presenter: Shukui Qin
Session: Poster Display session 2
Resources:
Abstract
4481 - Undetectable RAS mutant clones in plasma: possible implication for therapy and prognosis in the patient with RAS mutant metastatic colorectal cancer?
Presenter: Mohamed Bouchahda
Session: Poster Display session 2
Resources:
Abstract
5074 - Dihydropyrimidine dehydrogenase (DPD) determination prior the administration of medicines containing fluorouracil: a single Spanish hospital experience.
Presenter: Maria Dolores Mediano Rambla
Session: Poster Display session 2
Resources:
Abstract
5242 - Differences in survival between right and left-sided colorrectal cancer (CRC) in every stage, a CARESS-CCR Group Study.
Presenter: Julia Alcaide-Garcia
Session: Poster Display session 2
Resources:
Abstract
1123 - Quality of Life (QoL) in patients with aflibercept (AFL) and FOLFIRI for metastatic colorectal cancer (mCRC) – Interim analysis with focus on mutational status of the non-interventional study QoLiTrap (AIO-LQ-0113)
Presenter: Roger von Moos
Session: Poster Display session 2
Resources:
Abstract
1212 - The cost of adverse event management in patients with RAS wild-type metastatic colorectal cancer treated with first-line cetuximab and panitumumab: an Italian healthcare payer perspective
Presenter: Karl Patterson
Session: Poster Display session 2
Resources:
Abstract