Abstract 306P
Background
Systemic chemotherapy (SC) has stood as the only first-line treatment for advanced intrahepatic cholangiocarcinoma (iCCA) over the past few decades. Immune checkpoint inhibitors (ICIs) have been proved to provide additional benefit in disease control. However, oncological outcome of iCCA remains poor and awaits further improvement with new treatment modalities. Lenvatinib plus pembrolizumab (Len-P) showed promising results as second line in iCCA. Consequently, our study sought to explore the safety and efficacy of Len-P as a first-line therapy for iCCA patients within real-world clinical practice.
Methods
We retrospectively enrolled 133 advanced iCCA patients who received Len-P or SC between May 2019 and May 2023. Overall survival (OS), progression-free survival (PFS), objective response rate (ORR), disease-control rate (DCR) and adverse events (AEs) were compared between the two groups.
Results
There were 72 patients and 61 patients in the Len-P group and SC group, respectively. The median OS for the Len-P and SC groups was 16.3 and 17.8 months, respectively. Meanwhile, the median PFS times for the Len-P and SC groups was 8.9 and 11.4 months, respectively. There was no significant difference in ORR and DCR between the Len-P and SC group (ORR: 22.2% vs 23%; P = 0.92; DCR: 69.4% vs 77%; P = 0.58). In addition, the overall incidence of AEs was lower in the Len-P group than SC group. Low inflammation-based scores were indicative of favorable prognoses in patients undergoing Len-P.
Conclusions
This study demonstrated that the effect of Len-P is comparable to SC as first-line therapy for patients with advanced iCCA, with highly improved safety. It emerges as a viable treatment alternative for advanced iCCA. Inflammation-based scores show potential utility in identifying individuals likely to derive heightened benefits from Len-P therapy.
Legal entity responsible for the study
Sun Yat-sen University Cancer Center.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.