Fluropyrimidine single agent or doublet chemotherapy as second line treatment in advanced biliary tract cancer.

Fiche publication

Date publication

juin 2020

Journal

International journal of cancer

Auteurs

Membres identifiés du Cancéropôle Est :
Dr VERNEREY Dewi , Dr VIENOT Angélique , Mme MEURISSE Aurélia

Tous les auteurs :
Neuzillet C, Casadei-Gardini A, Brieau B, Vivaldi C, Brandi G, Tougeron D, Filippi R, Vienot A, Silvestris N, Pointet AL, Lonardi S, Rousseau B, Scartozzi M, Dahan L, Aprile G, Sourd SL, Evesque L, Meurisse A, Lièvre A, Vernerey D,

Lien Pubmed

https://www.ncbi.nlm.nih.gov/pubmed/32525595

Résumé

Fluoropyrimidine (FP) plus platinum chemotherapy has been recently established as a second-line (L2) preferred option in advanced biliary tract cancer (aBTC) (ABC-06 phase III trial). However, the overall survival (OS) benefit was limited and comparison with FP monotherapy was not available. Our aim was to assess the OS of patients treated with a FP monotherapy compared to a doublet with irinotecan or platinum in L2. We performed a retrospective analysis of two large multicenter prospective cohorts: a French cohort (28 centers) and an Italian cohort (9 centers). All consecutive patients with aBTC receiving FP-based L2 after GEMCIS/GEMOX L1 between 2003 and 2016 were included. A subgroup analysis according to performance status (PS) and an exploratory analysis according to platinum sensitivity in L1 were planned. In the French cohort (n = 351), no significant OS difference was observed between the FP monotherapy and doublet groups (median OS: 5.6 vs 6.8 months, P = 0.65). Stratification on ECOG PS showed similar results in PS 0-1 and 2. Median OS was not different between FP monotherapy, platinum- and irinotecan-based doublets (5.6 vs 7.1 vs 6.7 months, P = 0.68). Similar findings were observed in the Italian cohort (n = 174) and in the sensitivity analysis in pooled cohorts (n = 525). No L2 regimen seemed superior over others in the platinum resistant/refractory or sensitive subgroups. Our results suggest that FP monotherapy is as active as FP doublets in aBTC in L2, regardless of the patient PS and country, and could be a therapeutic option in this setting.