Abstract 70P
Background
Biliary tract cancers (BTC) are rare and heterogeneous cancers with poor prognosis. Several genomic alterations and genomic targets have been described.
Methods
We performed a retrospective analysis on BTC patients who had a molecular portrait between 2011 and 2019 at Gustave Roussy. The primary objective was to evaluate the prognostic factor of molecular aberrations.
Results
Two hundred and twelve patients (pts) were enrolled. The main characteristics were as follow: median age 61 y/o, female 51%, intrahepatic cholangiocarcinoma 57%, median of 2 previous lines. Of 212 BTC patients, 170 patients had a genomic profile based on archival tissue or a new tumor biopsy (IGR panel n = 117; Foundation One panel n = 95). 460 genomic alterations have been identified among 122 different genes. The most common altered genes were TP53 (9.4%), CDKN2A (7.4%), CDKN2B (5.7%), KRAS (5.4%), IDH1 (4.4%), FGFR2 (4.1%) and PIK3CA (3.7%). TP53 (p=0.008) and HER (p=0.04) were bad prognostic factors whereas FGFR2 fusion was associated with a better prognosis (p=0.03). No significant difference was observed for CDKN2A, CDKN2B, KRAS, IDH, PIK3CA, MYC alteration. Sixty-eight patients had genomic alteration considered as actionable and 58 received the matched targeted therapy. In the treated population, the objective response rate was 36.2% and the disease control rate 85.1%. Progression-free survival (PFS) was 6.2 months compared to 2.8 months (p = 0.02) for patients who did not received targeted treatment.
Conclusions
Biliary tract cancers frequently harbor genomic alterations some of which can lead to specific treatments. that have a prognostic impact. Prognostic role of each molecular abnormality should be studied in order to best assess the potential benefit of treatments.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Antoine Hollebecque.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.