Gemcitabine with cisplatin versus hepatic arterial infusion pump chemotherapy for liver-confined unresectable intrahepatic cholangiocarcinoma Journal Article

   

Authors:	Franssen, S.; Holster, J. J.; Jolissaint, J. S.; Nooijen, L. E.; Cercek, A.; D’Angelica, M. I.; Homs, M. Y. V.; Wei, A. C.; Balachandran, V. P.; Drebin, J. A.; Harding, J. J.; Kemeny, N. E.; Kingham, T. P.; Klümpen, H. J.; Mostert, B.; Swijnenburg, R. J.; Soares, K. C.; Jarnagin, W. R.; Groot Koerkamp, B.
Article Title:	Gemcitabine with cisplatin versus hepatic arterial infusion pump chemotherapy for liver-confined unresectable intrahepatic cholangiocarcinoma
Abstract:	Background: A post-hoc analysis of ABC trials included 34 patients with liver-confined unresectable intrahepatic cholangiocarcinoma (iCCA) who received systemic chemotherapy with gemcitabine and cisplatin (gem-cis). The median overall survival (OS) was 16.7 months and the 3-year OS was 2.8%. The aim of this study was to compare patients treated with systemic gem-cis versus hepatic arterial infusion pump (HAIP) chemotherapy for liver-confined unresectable iCCA. Methods: We retrospectively collected consecutive patients with liver-confined unresectable iCCA who received gem-cis in two centers in the Netherlands to compare with consecutive patients who received HAIP chemotherapy with or without systemic chemotherapy in Memorial Sloan Kettering Cancer Center. Results: In total, 268 patients with liver-confined unresectable iCCA were included; 76 received gem-cis and 192 received HAIP chemotherapy. In the gem-cis group 42 patients (55.3%) had multifocal disease compared with 141 patients (73.4%) in the HAIP group (p = 0.023). Median OS for gem-cis was 11.8 months versus 27.7 months for HAIP chemotherapy (p < 0.001). OS at 3 years was 3.5% (95% confidence interval [CI] 0.0–13.6%) in the gem-cis group versus 34.3% (95% CI 28.1–41.8%) in the HAIP chemotherapy group. After adjusting for male gender, performance status, baseline hepatobiliary disease, and multifocal disease, the hazard ratio (HR) for HAIP chemotherapy was 0.27 (95% CI 0.19–0.39). Conclusions: This study confirmed the results from the ABC trials that survival beyond 3 years is rare for patients with liver-confined unresectable iCCA treated with palliative gem-cis alone. With HAIP chemotherapy, one in three patients was alive at 3 years. © 2023, The Author(s).
Keywords:	adult; cancer chemotherapy; clinical article; treatment outcome; aged; cancer surgery; retrospective studies; overall survival; bevacizumab; cisplatin; chemoembolization; monotherapy; systemic therapy; capecitabine; gemcitabine; paclitaxel; antineoplastic agent; carboplatin; tumor volume; antineoplastic combined chemotherapy protocols; ca 19-9 antigen; cohort analysis; retrospective study; irinotecan; liver; multicenter study; sex difference; intrahepatic cholangiocarcinoma; bile duct carcinoma; bile duct neoplasms; bile ducts, intrahepatic; cholangiocarcinoma; oxaliplatin; radiofrequency ablation; deoxycytidine; hepatobiliary disease; bile duct tumor; intrahepatic bile duct; yttrium 90; irreversible electroporation; infusion pumps; humans; human; male; female; article; ecog performance status; microwave thermotherapy; doxecitine
Journal Title:	Annals of Surgical Oncology
Volume:	31
Issue:	1
ISSN:	1068-9265
Publisher:	Springer
Date Published:	2024-01-01
Start Page:	115
End Page:	124
Language:	English
DOI:	10.1245/s10434-023-14409-z
PUBMED:	37814188
PROVIDER:	scopus
PMCID:	PMC10695893
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85173922875&doi=10.1245%2fs10434-023-14409-z&partnerID=40&md5=1420271f0f632349afbfc50ca2c9ada7
Notes:	Article -- Source: Scopus

https://synapse.mskcc.org/synapse/works/has_related_data_chk/212419