Biliary tract cancers represent a heterogeneous group of tumors that includes intrahepatic cholangiocarcinoma (CCA), extrahepatic CCA, and gallbladder carcinoma. Teresa Macarulla, MD, PhD, Hospital Universitario Vall d’Hebron, Barcelona, Spain, and colleagues conducted a study to characterize the epidemiology of patients with biliary tract cancer, including patient management and survival outcomes. Dr Macarulla presented the results at the 2022 ASCO GI Cancers Symposium.
This analysis was based on data from the nationwide Spanish RETUD registry of patients who were diagnosed with biliary tract cancer between January 1, 2017, and December 31, 2020. These data include sociodemographic and clinical outcomes, molecular analysis, pharmacologic treatment, and survival. The data cutoff date was July 7, 2021.
A total of 778 evaluable patients were included in the analysis. The patients’ median age was 72.2 years (range, 64.5-78.5 years), 54.8% were men, 57.2% had a primary diagnosis of intrahepatic CCA, 27.4% had extrahepatic CCA, 13.8% had gallbladder cancer, and 48.8% had metastatic disease at diagnosis.
At the data cutoff, 525 (67.5%) patients had metastatic disease, and the main metastatic sites were the liver (63.4%), distant lymph nodes (35.6%), and peritoneum (33.3%).
Among the 245 (31.5%) patients with biliary tract cancers evaluable for biomarker analysis, 33 (17.7%) patients had IDH1 mutations, 15 (8.4%) had FGFR2 fusions, 10 (5.7%) had BRAF V600E mutations, 14 (6.8%) had microsatellite instability, and 5 (3%) had HER2 amplification.
Previous surgeries were reported in 261 (33.5%) patients, and 586 (75.3%) patients had received systemic therapies. The majority (93.7%) of patients received first-line therapy, 40.4% received second-line therapy, and 19.3% received third-line and beyond; in addition, 23% of patients received adjuvant therapy, and 1.9% received neoadjuvant therapy.
The main first-line therapy (64.4%) was cisplatin plus gemcitabine, followed by gemcitabine monotherapy (19.5%), and gemcitabine plus oxaliplatin (9.3%). The median progression-free survival in the cohort receiving first-line cisplatin plus gemcitabine was 5.1 months (95% confidence interval [CI], 4.6-5.8); the median overall survival in the metastatic population was 8.3 months (95% CI, 7.2-9.1).
Overall, these epidemiologic data from the Spanish registry in patients with biliary tract cancer are consistent with the published literature. The investigators noted that molecular profiling, which is recognized as important in the diagnosis of patients with CCA, is still underutilized in Spain.
Macarulla T, Barrero M, Adeva J, et al. Epidemiological biliary tract cancer characterization: a patient cohort from the Spanish RETUD registry. Abstract 480.
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