Abstract 294P
Background
Little is known about patients (pts) treated in hospital for iCCA and patterns of care in daily clinical practice. This work aimed at updating the clinical outcome from our previous study (2014-2015) [1] and analysing treatment lines in French iCCA pts.
Methods
An observational retrospective study was performed on the French National Hospital discharge database. All pts with a new diagnosis of iCCA who had a first hospital stay (S1) from January 1, 2016, to December 31, 2021 were included. They were followed up until December 31, 2021, or in-hospital death, whichever occurred first. Pts comorbidities were identified thanks to ICD-10, treatments, and surgical procedure codes during the 4 years before S1. Crude annual hospitalization rates were computed. Treatment lines were identified from 2012 to 2021 with an artificial intelligence algorithm (ATLAS) [2]). A multi-state model was used to compute the transition rates between lines on eligible patients with at least 4 chemotherapy sessions/one surgery/one radioembolisation.
Results
Overall, 13,491 pts were included and the mean (SD) follow-up duration was 13.1 (17.9) months. Median age at S1 was 72.0 (≥75 years: 42.8%), 44.1% were female, 20.7% were admitted via emergency services for S1, and 32.1% had metastases. Declared underlying liver disease included cirrhosis (9.4%), hepatitis B (0.8%) and C (1.3%), and NASH (0.6%). Between 2016 and 2021, the crude annual rate of new iCCA cases increased from 3.08 (2.94-3.24) in 2016 (N=1,598) to 4.12 (3.95-4.29) per 100,000 adult person-years in 2021 (N=2,188). On 4,855 eligible pts, considering that one treatment line extends to the next (untreated state not considered), the one-year persistence rate for first line (L1) of systemic therapy was 35%. Among patients receiving L1, 37.7% (36.0-39.3%) received a second line 2 (L2) during the follow-up. The median time between the start of L1 and the beginning of L2 was 7.0 months.
Conclusions
This study provides up-to-date national real-world data on iCCA, revealing an increasing burden year by year in France, a poor outcome of iCCA patients on L1 systemic therapy and the low proportion of pts receiving a L2. [1] Lancet Reg Health Eur 2022 [2] IEEE CIBCB 2019.
Legal entity responsible for the study
Les Laboratoires Servier.
Funding
Les Laboratoires Servier.
Disclosure
A. Lievre: Financial Interests, Personal, Invited Speaker: Amgen, Astellas, AstraZeneca, Bristol Myers Squibb, Esteve, Ipsen, Leo-Pharma, Mylan, Pierre Fabre, Servier, Viatris; Financial Interests, Personal, Advisory Board: Astellas, Bayer, Bristol Myers Squibb, Incyte, Pierre Fabre, Servier; Financial Interests, Personal, Other, Transport/Conference registration: Bayer, Boehringer Ingelheim, Ipsen, Mylan, Pierre Fabre, Roche, Servier, Viatris; Financial Interests, Institutional, Research Grant: Bayer, Lilly. C. Neuzillet: Financial Interests, Personal, Advisory Board: Amgen, AstraZeneca, Baxter, Bristol Myers Squibb, Fresenius Kabi, Incyte Biosciences, Mayoly, Merck, MSD, Mundipharma, Nestlé Health Science, Novartis, Nutricia, OSE Immunotherapeutics, Pierre Fabre, Roche, Sanofi, Servier, Viatris; Financial Interests, Institutional, Research Grant: AstraZeneca, Bristol Myers Squibb, Fresenius Kabi, Nutricia, OSE Immunotherapeutics, Roche, Servier, Viatris. All other authors have declared no conflicts of interest.