Abstract 314P
Background
Biliary Tract Cancers (BTC) are heterogeneous group of malignancies encompassing Gall Bladder, Ampullary, and Cholangiocarcinoma (CCA). BTC typically present at advanced stages, leading to poor prognoses. The incidence & mortality of BTC is rising. The standard first-line chemotherapy, as per the ABC-02 study since 2010, involves cisplatin and gemcitabine. Recently, Durvalumab in combination with chemotherapy (TOPAZ-1 study) has gained approval. For frail patients unfit for cisplatin, carboplatin serves as an alternative.
Methods
We conducted a retrospective analysis of median overall survival (mOS) and progression-free survival (mPFS) among patients with locally advanced or metastatic BTC treated with carboplatin and gemcitabine between April 2018 and March 2023 by identifying patients from multidisciplinary team records of university hospital. Data analysis was conducted using SPSS Statistics, Version 28.0. Survival analysis was done using Kaplan Meier curve to estimate cumulative survival possibilities. Log rank test was used to compare differences between survival rates.
Results
Of the 66 patients studied (58.2% males, mean age 68.2 years), the mOS was 8.97 months (95% CI:6.78-11.16), and mPFS was 5.88 months (95% CI:4.78-6.98). mOS varied among cancer types: gall bladder cancer (6.57 months), intra-hepatic CCA (7.46 months), peri-hilar CCA (9.17 months), extra-hepatic CCA (10.94 months), and ampullary cancer (14.1 months). The corresponding mPFS for these types was 2.95 months, 5.88 months, 5.78 months, 6.37 months, and 8.02 months, respectively. Significantly poor mOS & mPFS was noted in patients receiving less than 4 cycles of chemotherapy; baseline CA19.9 >2000; baseline ALP >180; baseline Albumin <34; baseline Bilirubin >13; and baseline Neutrophil Lymphocyte ratio >4 (all ps<0.05). Common toxicities included haematological, with thrombocytopenia (60.6%), neutropenia (48.5%), and anaemia (50.0%) being notable.
Conclusions
Despite the limited sample size, our study underscores the efficacy of carboplatin-based chemotherapy regimen in treating advanced biliary tract cancers. Additionally, it sheds light on clinical parameters influencing survival outcomes.
Legal entity responsible for the study
Arvind Arora.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.