First Line and Second Line Chemotherapy in Advanced Cholangiocarcinoma and Impact of Dose Reduction of Chemotherapy: A Retrospective Analysis

ObjectivePrognosis of patients with irresectable cholangiocarcinoma is still poor. The ABC-02 trial established the current first line (1L) standard systemic chemotherapy (CT) with gemcitabine/platinum derivate for advanced cholangiocarcinoma. However, the majority of patients needed therapy adaptio...

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Autores principales:	Christian Möhring, Jan Feder, Raphael U. Mohr, Farsaneh Sadeghlar, Alexandra Bartels, Robert Mahn, Taotao Zhou, Milka Marinova, Georg Feldmann, Peter Brossart, Martin von Websky, Hanno Matthaei, Steffen Manekeller, Tim Glowka, Jörg C. Kalff, Tobias J. Weismüller, Christian P. Strassburg, Maria A. Gonzalez-Carmona
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	bile duct carcinoma cholangiocellular carcinoma first line palliative chemotherapy second line palliative chemotherapy retrospective analysis gemcitabine/cisplatin Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/3a0b0c8729054bd493c1b136c9000bca
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spelling	oai:doaj.org-article:3a0b0c8729054bd493c1b136c9000bca2021-11-10T06:33:21ZFirst Line and Second Line Chemotherapy in Advanced Cholangiocarcinoma and Impact of Dose Reduction of Chemotherapy: A Retrospective Analysis2234-943X10.3389/fonc.2021.717397https://doaj.org/article/3a0b0c8729054bd493c1b136c9000bca2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fonc.2021.717397/fullhttps://doaj.org/toc/2234-943XObjectivePrognosis of patients with irresectable cholangiocarcinoma is still poor. The ABC-02 trial established the current first line (1L) standard systemic chemotherapy (CT) with gemcitabine/platinum derivate for advanced cholangiocarcinoma. However, the majority of patients needed therapy adaptions. Thus, the aim of this study was to evaluate 1L and second line (2L) therapy regimens and the impact of therapy adaptions in an unselected real-life cohort of patients with advanced cholangiocarcinoma.Materials and MethodsThis is a single institution retrospective analysis of patients with irresectable cholangiocarcinoma who were treated with gemcitabine/platinum derivate from 2010 to 2018. Overall survival (OS), progression-free survival (PFS) and toxicity were analyzed for all patients, especially with regard to CT de-escalation.ResultsFifty-eight patients receiving gemcitabine/platinum derivate were included in the analysis. Median OS and PFS were 12.2 and 6.9 months. Interestingly, 41 patients (71%) needed therapy de-escalation. However, despite reduced CT exposition, there was no-significant difference in OS (10.8 months vs. 15.6 months, p = 0.127), and patients suffered from less adverse events during CT. 21 (36%) patients reached 2L CT, most often with FOLFIRI (57%). Survival beyond the end of 1L CT was 7.1 months with 2L CT vs. 2.9 months with BSC.ConclusionIn our study, the combination of gemcitabine/platinum derivate showed similar OS and PFS as randomized prospective phase II/III trials. Therapy regimen adaptions were needed in the majority of patients. However, individualized modifications of the therapy regimen allowed better tolerance as well as continuation of therapy and did not significantly influence median OS. Furthermore, our study revealed a potential survival benefit with 2L CT for selected patients.Christian MöhringJan FederRaphael U. MohrFarsaneh SadeghlarAlexandra BartelsRobert MahnTaotao ZhouMilka MarinovaGeorg FeldmannPeter BrossartMartin von WebskyHanno MatthaeiSteffen ManekellerTim GlowkaJörg C. KalffTobias J. WeismüllerChristian P. StrassburgMaria A. Gonzalez-CarmonaFrontiers Media S.A.articlebile duct carcinomacholangiocellular carcinomafirst line palliative chemotherapysecond line palliative chemotherapyretrospective analysisgemcitabine/cisplatinNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENFrontiers in Oncology, Vol 11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	bile duct carcinoma cholangiocellular carcinoma first line palliative chemotherapy second line palliative chemotherapy retrospective analysis gemcitabine/cisplatin Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	bile duct carcinoma cholangiocellular carcinoma first line palliative chemotherapy second line palliative chemotherapy retrospective analysis gemcitabine/cisplatin Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Christian Möhring Jan Feder Raphael U. Mohr Farsaneh Sadeghlar Alexandra Bartels Robert Mahn Taotao Zhou Milka Marinova Georg Feldmann Peter Brossart Martin von Websky Hanno Matthaei Steffen Manekeller Tim Glowka Jörg C. Kalff Tobias J. Weismüller Christian P. Strassburg Maria A. Gonzalez-Carmona First Line and Second Line Chemotherapy in Advanced Cholangiocarcinoma and Impact of Dose Reduction of Chemotherapy: A Retrospective Analysis
description	ObjectivePrognosis of patients with irresectable cholangiocarcinoma is still poor. The ABC-02 trial established the current first line (1L) standard systemic chemotherapy (CT) with gemcitabine/platinum derivate for advanced cholangiocarcinoma. However, the majority of patients needed therapy adaptions. Thus, the aim of this study was to evaluate 1L and second line (2L) therapy regimens and the impact of therapy adaptions in an unselected real-life cohort of patients with advanced cholangiocarcinoma.Materials and MethodsThis is a single institution retrospective analysis of patients with irresectable cholangiocarcinoma who were treated with gemcitabine/platinum derivate from 2010 to 2018. Overall survival (OS), progression-free survival (PFS) and toxicity were analyzed for all patients, especially with regard to CT de-escalation.ResultsFifty-eight patients receiving gemcitabine/platinum derivate were included in the analysis. Median OS and PFS were 12.2 and 6.9 months. Interestingly, 41 patients (71%) needed therapy de-escalation. However, despite reduced CT exposition, there was no-significant difference in OS (10.8 months vs. 15.6 months, p = 0.127), and patients suffered from less adverse events during CT. 21 (36%) patients reached 2L CT, most often with FOLFIRI (57%). Survival beyond the end of 1L CT was 7.1 months with 2L CT vs. 2.9 months with BSC.ConclusionIn our study, the combination of gemcitabine/platinum derivate showed similar OS and PFS as randomized prospective phase II/III trials. Therapy regimen adaptions were needed in the majority of patients. However, individualized modifications of the therapy regimen allowed better tolerance as well as continuation of therapy and did not significantly influence median OS. Furthermore, our study revealed a potential survival benefit with 2L CT for selected patients.
format	article
author	Christian Möhring Jan Feder Raphael U. Mohr Farsaneh Sadeghlar Alexandra Bartels Robert Mahn Taotao Zhou Milka Marinova Georg Feldmann Peter Brossart Martin von Websky Hanno Matthaei Steffen Manekeller Tim Glowka Jörg C. Kalff Tobias J. Weismüller Christian P. Strassburg Maria A. Gonzalez-Carmona
author_facet	Christian Möhring Jan Feder Raphael U. Mohr Farsaneh Sadeghlar Alexandra Bartels Robert Mahn Taotao Zhou Milka Marinova Georg Feldmann Peter Brossart Martin von Websky Hanno Matthaei Steffen Manekeller Tim Glowka Jörg C. Kalff Tobias J. Weismüller Christian P. Strassburg Maria A. Gonzalez-Carmona
author_sort	Christian Möhring
title	First Line and Second Line Chemotherapy in Advanced Cholangiocarcinoma and Impact of Dose Reduction of Chemotherapy: A Retrospective Analysis
title_short	First Line and Second Line Chemotherapy in Advanced Cholangiocarcinoma and Impact of Dose Reduction of Chemotherapy: A Retrospective Analysis
title_full	First Line and Second Line Chemotherapy in Advanced Cholangiocarcinoma and Impact of Dose Reduction of Chemotherapy: A Retrospective Analysis
title_fullStr	First Line and Second Line Chemotherapy in Advanced Cholangiocarcinoma and Impact of Dose Reduction of Chemotherapy: A Retrospective Analysis
title_full_unstemmed	First Line and Second Line Chemotherapy in Advanced Cholangiocarcinoma and Impact of Dose Reduction of Chemotherapy: A Retrospective Analysis
title_sort	first line and second line chemotherapy in advanced cholangiocarcinoma and impact of dose reduction of chemotherapy: a retrospective analysis
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/3a0b0c8729054bd493c1b136c9000bca
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First Line and Second Line Chemotherapy in Advanced Cholangiocarcinoma and Impact of Dose Reduction of Chemotherapy: A Retrospective Analysis

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