Abstract 290P
Background
Biliary tract cancer (BTC), including gallbladder cancer (GBC), intrahepatic and extrahepatic cholangiocarcinoma (iCCA/eCCA), represents approximately 1% of adult cancers, though BTC epidemiology is not well understood.
Methods
MEDLINE®, Embase® along with cancer surveillance websites and supplementary web searches were undertaken from 1st January 2014 to 26th July 2023. Studies were selected using pre-specified criteria.
Results
The greatest proportion of studies reported US data, most commonly using Surveillance, Epidemiology, and End Results (SEER) registries. Global, multi- and specific-country studies were also identified. In the US, the incidence of BTC per 100,000 person years (PY) rose from 3.5 in 2000 to 4.4 in 2018 (annual percentage change (APC) 1.4 (95% CI: 1.1–1.8)). The global age standardized incidence rate (ASRI) decreased from 3.13 (95% CI 3.02–3.46) in 1990 to 2.71 (95% CI 2.39–2.89) per 100,000 PY in 2017 (APC -0.56 (95% CI: -0.67 to -0.45)). In 2008-12, the ASRI of BTC per 100,000 PY was higher in Asia (1.12 [Vietnam] to 9 [Republic of Korea]) and South America (2.73 [Brazil] to 12.42 [Chile]) than in EU (2.0 [UK] to 3.6 [Italy]) and North America (2.32 [US] and 2.35 [Canada]). In the US (2001-17), CCA ASRI was 3.65 per 100,000 PY (iCCA, 1.19; eCCA, 2.46), marking a 43.8% rise from 3.08 in 2001 to 4.43 in 2017. In the EU (2008-12), eCCA and iCCA varied from 0.12 per 100,000 PY in Poland to 1.01 in France. In 2018, GBC had the highest incidence among all BTC subtypes in most countries. ASRI in Eastern Asia was 3.0 per 100,000 PY, followed by South America (2.8) and Melanesia (2.7). However, Middle Africa had the lowest rates at 0.35. Molecular profiling reveals an emerging landscape of genetic alterations in BTC although frequency varies by subtype. Within targetable molecules, for example, FGFR2 rearrangements and IDH1/2 mutations were more commonly observed in iCCA whereas HER2 overexpression and alterations were more prevalent in eCCA and GBC.
Conclusions
The variation in incidence across regions and BTC subtypes highlights the pattern of unmet need in BTC populations. Advances in the understanding of genetic alterations will allow further innovation in precision medicine and improvement in patient outcomes.
Legal entity responsible for the study
Jazz Pharmaceuticals.
Funding
Jazz Pharmaceuticals.
Disclosure
J.A. Bridgewater: Financial Interests, Personal, Advisory Board: Taiho, BMS, Incyte, Basilea, Servier; Financial Interests, Personal, Other, Advisor: AstraZeneca; Financial Interests, Institutional, Funding: Incyte. A. Ahuja, V. Sharma, S. Paisley, E. Breislin: Financial Interests, Personal, Full or part-time Employment: Lumanity; Financial Interests, Personal, Other, Consultancy time: Jazz Pharmaceuticals. J. Sabater, S. Mettam, L. Fan, S. Bowditch: Financial Interests, Personal, Full or part-time Employment: Jazz Pharmaceuticals; Financial Interests, Personal, Stocks/Shares: Jazz Pharmaceuticals. W. Su: Financial Interests, Personal, Stocks/Shares: Jazz Pharmaceuticals; Financial Interests, Personal, Full or part-time Employment: Jazz Pharmaceuticals.