Second-Line Chemotherapy for Intrahepatic Cholangiocarcinomas: What Is the Real Gain?

Author:

Garajová Ingrid1ORCID,Gelsomino Fabio2ORCID,Salati Massimiliano2,Mingozzi Anna1ORCID,Peroni Marianna1,De Lorenzo Stefania3,Granito Alessandro4ORCID,Tovoli Francesco4ORCID,Leonardi Francesco1

Affiliation:

1. Medical Oncology Unit, University Hospital of Parma, 43126 Parma, Italy

2. Department of Oncology and Hematology, University Hospital of Modena, 41124 Modena, Italy

3. Oncology Unit, Azienda USL Bologna, 40127 Bologna, Italy

4. Division of Internal Medicine, Hepatobiliary and Immunoallergic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 41138 Bologna, Italy

Abstract

Background: The presence of actionable alterations in advanced biliary tract cancer patients opened new therapeutic possibilities for second-line treatments. However, for around 60% of the patients, chemotherapy remains the only therapeutic option. The aim of our study was to evaluate outcomes and prognostic parameters in patients with intrahepatic cholangiocarcinomas treated with second-line chemotherapy. Methods: A total of 255 consecutive metastatic intrahepatic cholangiocarcinoma (ICC) patients were retrospectively reviewed and clinicopathologic and survival data were collected. Results: Fourty-four percent of ICC patients underwent second-line chemotherapy. In particular, younger ICC patients with better ECOG PS status, and with disease control after first-line chemotherapy were those who were treated with second-line treatments. Median progression-free survival in the patients treated with second-line chemotherapy was 3 months. Finally, the patients affected by intrahepatic cholangiocarcinoma with better ECOG PS, with prior surgical resection of the primary tumor, who responded to first-line chemotherapy, and had better progression-free survival with second-line chemotherapy, were associated with better outcomes in multivariate analysis. Conclusions: Not all patients seem to benefit from second-line chemotherapy. To improve therapeutic decisions, performance status and disease control with first-line chemotherapy should lead to the decision on the usefulness of second-line treatments in advanced ICC patients.

Publisher

MDPI AG

Subject

Paleontology,Space and Planetary Science,General Biochemistry, Genetics and Molecular Biology,Ecology, Evolution, Behavior and Systematics

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