Chemotherapy for biliary tract cancer: real-world experience in a single institute

Nagoya J Med Sci. 2020 Nov;82(4):725-733. doi: 10.18999/nagjms.82.4.725.

Abstract

The standard chemotherapy regimen for unresectable or recurrent biliary tract cancer is gemcitabine combined with cisplatin (GC). To evaluate the effectiveness and safety of chemotherapy in patients with unresectable or recurrent biliary tract cancer in the real world, we retrospectively analyzed the clinical courses of patients who underwent chemotherapy with GC from January 2015 to November 2019. Forty-eight patients underwent the GC regimen. One patient (2.1%) achieved a complete response, seven patients (14.6%) achieved a partial response, 26 patients (54.2) achieved stable disease, 11 patients (22.9%) achieved progressive disease, and 3 patients (6.3%) were not evaluable. The overall response rate was 16.7%. The median overall survival was 14.2 months (95% CI: 13.8-14.6), and the median progression-free survival was 7.7 months (95% CI: 4.2-11.2). Thirty-nine patients (81.3%) experienced grade 3 or higher severe adverse events as follows: 54.2% experienced neutropenia, 20.8% experienced anemia, 12.5% experienced thrombocytopenia and 20.8% experienced biliary tract infection. As a second-line chemotherapy, S-1 was used in seventeen patients, and stable disease was achieved in three patients (17.6%). The GC regimen for biliary tract cancer is effective and safe for unresectable or recurrent biliary tract cancer in routine clinical practice.

Keywords: S-1; biliary tract cancer; cholangiocarcinoma; cisplatin; gemcitabine.

MeSH terms

  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / standards
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Biliary Tract Neoplasms* / drug therapy
  • Biliary Tract Neoplasms* / epidemiology
  • Biliary Tract Neoplasms* / pathology
  • Cisplatin* / administration & dosage
  • Cisplatin* / adverse effects
  • Deoxycytidine / administration & dosage
  • Deoxycytidine / adverse effects
  • Deoxycytidine / analogs & derivatives*
  • Drug-Related Side Effects and Adverse Reactions* / diagnosis
  • Drug-Related Side Effects and Adverse Reactions* / etiology
  • Female
  • Gemcitabine
  • Humans
  • Japan / epidemiology
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local* / drug therapy
  • Neoplasm Recurrence, Local* / epidemiology
  • Neoplasm Recurrence, Local* / pathology
  • Neoplasm Staging
  • Practice Patterns, Physicians' / statistics & numerical data
  • Progression-Free Survival
  • Retrospective Studies

Substances

  • Antineoplastic Agents
  • Deoxycytidine
  • Cisplatin
  • Gemcitabine