125P - Real-world treatment patterns in patients with biliary tract cancer (BTC): Retrospective chart review survey in Europe (GARNET-2)

Background

BTC is a diverse group of hepatic and perihepatic malignancies with a 5-year survival rate of <20%. This study described real-world treatment patterns and outcomes among patients with advanced and/or unresectable (aBTC) in France, Germany, Italy, Spain, and the United Kingdom (UK).

Methods

In this retrospective, web-based chart review survey, physicians reported anonymized patient-level data for adult patients diagnosed with aBTC between May 2018 and October 2021 who received first-line (1L) systemic therapy (index date). Patients were followed from index date until death or last available date at abstraction. Patient characteristics, treatment patterns, and clinical outcomes were summarized descriptively.

Results

A total of 196 physicians extracted data for 792 aBTC patients who initiated 1L systemic therapy. More patients had intrahepatic cholangiocarcinoma (CCA; 34.8%), than extrahepatic CCA (29.9%), gallbladder (23.5%), and ampullary cancer (10.2%) whereas 1.5% patients had missing information. During follow-up (median=12.4 months), less than half of patients were prescribed gemcitabine + cisplatin (GemCis; 47.9%) as 1L. Median 1L treatment duration was 5.3 months with disease progression (49.2%) being the most common reason for treatment discontinuation. Only 33.1% received 2L and 4.1% received 3L+ of treatment. Median real-world overall survival (rwOS) from index date was 13.4 months, with regional variation (Table).

Table: 125P

Key results by country*

*All decimals have been rounded to the nearest tenth, thus the overall % may result in getting a value slightly higher than 100%.

Conclusions

This study demonstrated the unmet needs of patients with aBTC, with less than half of the patients receiving standard-of-care – GemCis (ESMO recommendation) and a median rwOS of just over one year suggesting the need for new treatments that extend survival. With the recent approval of immunotherapy for aBTC patients, exploration of the benefits in real-world is needed. Additional efforts in the earlier detection of BTC are essential to improve survival.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

AstraZeneca.

Funding

AstraZeneca.

Disclosure

J.A. Bridgewater: Financial Interests, Personal, Advisory Board: Taiho, BMS, Incyte, Basilea, Servier; Financial Interests, Institutional, Funding: Incyte. M. Paskow: Financial Interests, Personal, Full or part-time Employment: AstraZeneca; Financial Interests, Personal, Stocks/Shares: AstraZeneca. A. Szende: Financial Interests, Personal, Full or part-time Employment: Labcorp Drug Development; Financial Interests, Personal, Stocks/Shares: Labcorp Drug Development. P. Messina: Financial Interests, Personal, Full or part-time Employment: Labcorp, IQVIA. J. Sah: Financial Interests, Personal, Stocks/Shares: AstraZeneca; Financial Interests, Personal, Full or part-time Employment: AstraZeneca. B. Baur: Financial Interests, Personal, Full or part-time Employment: AstraZeneca; Financial Interests, Personal, Stocks/Shares: AstraZeneca.