Hepatic intra-arterial and systemic chemotherapy followed by maintenance therapy for the treatment of cholangiocarcinoma

Abstract

Aim: The aim is to report clinical outcomes of hepatic intra-arterial (IACHT) and systemic chemotherapy (SCHT), followed by gemcitabine-based maintenance therapy (maintenance), for the treatment of relapsed or unresectable cholangiocarcinoma.

Patients & methods: In this retrospective observational study, 145 cholangiocarcinoma patients were treated with Epirubicin-Cisplatin as IACHT associated with Capecitabine or 5-fluorouracil as SCHT. Maintenance was performed with gemcitabine-based schedule. Toxicity was assessed with NCI-CTCAE and tumor response with RECIST 1.1.

Results: Tumor response was complete in 1%, partial in 20%, stable disease in 48% and progression in 31% of patients (3 months after therapy). The most frequent adverse events were: anemia (24%), nausea and vomiting (33%), alopecia (60%).

Conclusion: Cholangiocarcinoma patients may benefit from IAHCT-SCHT. Maintenance may prolong clinical benefits. ClinicalTrials.gov registry Identifier: NCT01920503.

Keywords: biliary tract cancer; cholangiocarcinoma; intra-arterial chemotherapy; tumor response.

Conflict of interest statement

Financial & competing interests disclosure The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. No writing assistance was utilized in the production of this manuscript.

Figures

Figure 1.. Tumor response after 3 months of therapy.

CR: Complete response; IACHT-SCHT: Intra-arterial chemotherapy-systemic chemotherapy ; PD: Progression disease; PR: Partial response; SD: Stable disease.

Figure 2.. Overall survival after first line therapy.

CR: Complete response; ECCA: Extrahepatic group; ICCA: Intrahepatic-cholangiocarcinoma group; PD: Progression disease; SD: Stable disease.

Figure 3.. Overall survival after mainte nan ce therapy.

ALL: Whole ICHT SCHT; ECA: Extrahepatic biliary cancer; ICCA: Intrahepatic cholangiocarcinoma.