Pattern of progression of intrahepatic cholangiocarcinoma: Implications for second‐line clinical trials
| العنوان: | Pattern of progression of intrahepatic cholangiocarcinoma: Implications for second‐line clinical trials |
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| المؤلفون: | Francesco Caputo, Piera Federico, Ingrid Garajová, Matteo Renzulli, Bruno Daniele, Massimo Iavarone, Alessandro Granito, Fabio Gelsomino, Stefania De Lorenzo, Matilde Coriano, Francesco Tovoli, Fabio Piscaglia, Massimiliano Salati |
| المساهمون: | Tovoli F., Garajova I., Gelsomino F., Iavarone M., Federico P., Salati M., Coriano M., Caputo F., De Lorenzo S., Granito A., Renzulli M., Daniele B., Piscaglia F. |
| المصدر: | Liver International. 42:458-467 |
| بيانات النشر: | Wiley, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | medicine.medical_specialty, Gastroenterology, liver cancer, FOLFOX, biliary tract cancer, Internal medicine, medicine, Humans, Intrahepatic Cholangiocarcinoma, Retrospective Studies, Hepatology, Performance status, business.industry, Liver Neoplasms, Hazard ratio, medicine.disease, Gemcitabine, Discontinuation, Bile Ducts, Intrahepatic, Bile Duct Neoplasms, Hepatocellular carcinoma, outcome, prognosis, cholangiocarcinoma, Liver cancer, business, medicine.drug |
| الوصف: | Background: Intrahepatic cholangiocarcinoma (iCCA) is the second most frequent liver cancer. The overall survival of iCCA and other biliary tract cancers (BTC) remains poor. Recently, the ABC-06 trial reported the superiority of FOLFOX vs clinical observation as a second-line treatment. Still, the survival benefit was less than expected. We hypothesized that the pattern of progression of iCCA can drive post-progression survival (PPS), similar to hepatocellular carcinoma. Methods: Multicentre retrospective evaluation of consecutive iCCA patients who progressed after frontline systemic treatment with gemcitabine as monotherapy or in combination with platinum. Radiological assessment of progression was evaluated according to RECIST 1.1. The progression pattern was divided according to the presence/absence of new extrahepatic lesions (NEH). Results: We included 206 patients from 5 centres. The median OS was 14.1months and its independent predictors (hazard ratio [HR], 95% confidence interval [CI]) were previous surgery 0.699 [0.509-0.961], performance status >2.445 [1.788-3.344], permanent first-line discontinuation 16.072 [5.102-50.633], registration of ascites 2.226 [1.448-3.420] or bilirubin >3mg/dl 3.004 [1.935-4.664] during the follow-up, and disease progression 2.523 [1.261-5.050]. The appearance of NEH independently predicted OS 2.18 [1.55-3.06] in patients with radiological progression. Amongst 138 patients eligible for second-line treatment, PPS was 16.8 and 5.9months in cases without and with NEH, respectively (P=.001). Progression owing to NEH lesions was an independent predictor of PPS 1.873 [1.333-2.662], together with performance status, time to progression to the frontline treatment, bilirubin >3mg/dl and ascites. Conclusions: PPS of iCCA is influenced by progression pattern, with important implications for second-line trial design and analysis. |
| وصف الملف: | ELETTRONICO |
| تدمد: | 1478-3231 1478-3223 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9290b947ce8df25ff01b0043f1ee574dTest https://doi.org/10.1111/liv.15117Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....9290b947ce8df25ff01b0043f1ee574d |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14783231 14783223 |
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