The Cholangiocarcinoma in the Young (CITY) Study: Tumor Biology, Treatment Patterns, and Survival Outcomes in Adolescent Young Adults With Cholangiocarcinoma-Reference-Cited by-同舟云学术

The Cholangiocarcinoma in the Young (CITY) Study: Tumor Biology, Treatment Patterns, and Survival Outcomes in Adolescent Young Adults With Cholangiocarcinoma

Published:2023-08 Issue:7 Volume: Page:
ISSN:2473-4284
Container-title:JCO Precision Oncology
language:en
Short-container-title:JCO Precision Oncology

Author:

Pappas Leontios¹²^ORCID,Baiev Islam¹,Reyes Stephanie³,Bocobo Andrea Grace⁴,Jain Apurva⁵^ORCID,Spencer Kristen⁶^ORCID,Le Tri Minh⁷,Rahma Osama E.⁸^ORCID,Maurer Jordan¹,Stanton Jen¹,Zhang Karen⁴^ORCID,De Armas Anaemy Danner⁵^ORCID,Deleon Thomas T.⁹,Roth Marc¹⁰^ORCID,Peters Mary Linton B.¹¹^ORCID,Zhu Andrew X.¹²¹³^ORCID,Boyhen Kylie¹⁴,VanCott Christine¹⁵,Patel Tushar¹⁶,Roberts Lewis R.¹⁷^ORCID,Lindsey Stacie¹⁸^ORCID,Horick Nora¹,Lennerz Jochen K.¹⁹^ORCID,Iafrate A. John¹⁹,Goff Laura Williams²⁰^ORCID,Mody Kabir²¹^ORCID,Borad Mitesh J.⁹^ORCID,Shroff Rachna T.²²,Javle Milind M.⁵^ORCID,Kelley R. Katie⁴^ORCID,Goyal Lipika¹²²³^ORCID

Affiliation:

1. Department of Medicine, Massachusetts General Hospital Cancer Center, Boston, MA

2. Harvard Medical School, Boston, MA

3. Duke University School of Medicine, Durham, NC

4. Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA

5. Division of Cancer Medicine, Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX

6. Department of Medicine, NYU Langone Health Perlmutter Cancer Center, NYU School of Medicine, New York, NY

7. Department of Medicine, University of Virginia Comprehensive Cancer Center, Charlottesville, VA

8. Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA

9. Division of Hematology/Oncology, Mayo Clinic, Scottsdale, AZ

10. Department of Medical Oncology, St Luke's Cancer Institute, Kansas City, MO

11. Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA

12. Jiahui International Cancer Center, Jiahui Health, Shanghai, China

13. I-MAB Biopharma, Shanghai, China

14. Yale University, New Haven, CT

15. Department of Medicine, HCA Florida South Tampa Hospital, Tampa, FL

16. Department of Transplantation, Mayo Clinic, Jacksonville, FL

17. Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN

18. The Cholangiocarcinoma Foundation, Herriman, UT

19. Center for Integrated Diagnostics, Department of Pathology, Massachusetts General Hospital/Harvard Medical School, Boston, MA

20. Department of Medicine, Vanderbilt-Ingram Cancer Center, Nashville, TN

21. Division of Hematology/Oncology, Mayo Clinic, Jacksonville, FL

22. University of Arizona Cancer Center, University of Arizona, Tucson, AZ

23. Department of Medicine, Division of Oncology, Stanford Cancer Center, Palo Alto, CA

Abstract

PURPOSE Increased awareness of the distinct tumor biology for adolescents and young adults (AYAs) with cancer has led to improvement in outcomes for this population. However, in cholangiocarcinoma (CCA), a paucity of data exist on the AYA population. To our knowledge, we present the largest study to date on AYA disease biology, treatment patterns, and survival outcomes in CCA. METHODS A multi-institutional cohort of patients with CCA diagnosed with intrahepatic cholangiocarcinoma (ICC) or extrahepatic cholangiocarcinoma (ECC) was used for analysis. Retrospective chart review was conducted on patients who were 50 years old and younger (young; n = 124) and older than 50 years (older; n = 723). RESULTS Among 1,039 patients screened, 847 patients met eligibility (72% ICC, 28% ECC). Young patients had a larger median tumor size at resection compared with older patients (4.2 v 3.6 cm; P = .048), more commonly had N1 disease (65% v 43%; P = .040), and were more likely to receive adjuvant therapy (odds ratio, 4.0; 95% CI, 1.64 to 9.74). Tumors of young patients were more likely to harbor an FGFR2 fusion, BRAF mutation, or ATM mutation ( P < .05 for each). Young patients were more likely to receive palliative systemic therapy (96% v 69%; P < .001), targeted therapy (23% v 8%; P < .001), and treatment on a clinical trial (31% v 19%; P = .004). Among patients who presented with advanced disease, young patients had a higher median overall survival compared with their older counterparts (17.7 v 13.5 months; 95% CI, 12.6 to 22.6 v 11.4 to 14.8; P = .049). CONCLUSION Young patients with CCA had more advanced disease at resection, more commonly received both adjuvant and palliative therapies, and demonstrated improved survival compared with older patients. Given the low clinical trial enrollment and poor outcomes among some AYA cancer populations, data to the contrary in CCA are highly encouraging.

Publisher

American Society of Clinical Oncology (ASCO)

Subject

Cancer Research,Oncology

Link

https://ascopubs.org/doi/pdfdirect/10.1200/PO.22.00594

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