Chemotherapies Compared in Intrahepatic Cholangiocarcinoma: Retrospective View of ABC Trials

By: Joshua Swore, PhD
Posted: Wednesday, November 8, 2023

A retrospective study published in the Annals of Surgical Oncology explored and confirmed some of the results within the ABC trials, finding limited life expectancy among patients with liver-confined unresectable intrahepatic cholangiocarcinoma who received palliative gemcitabine and cisplatin. In fact, the 3-year overall survival rate was 3.5% with systemic chemotherapy alone, compared with 34.3% with hepatic arterial infusion pump (HAIP) chemotherapy, according to Bas Groot Koerkamp, MD, PhD, of Erasmus MC Cancer Institute, Rotterdam, the Netherlands, and colleagues.

The post hoc analysis included 268 patients from the ABC trials. All patients had liver-confined unresectable intrahepatic cholangiocarcinoma. A total of 76 patients received systemic chemotherapy plus gemcitabine and cisplatin, and 192 received HAIP chemotherapy.

The authors reported that among patients treated with gemcitabine and cisplatin, 42 had multifocal disease vs the 141 who received HAIP chemotherapy. An investigation into overall survival found that those within the gemcitabine and cisplatin cohort had a median overall survival of 11.8 months compared with 27.7 months for those who received HAIP chemotherapy. As mentioned, the 3-year overall survival rate was higher with HAIP chemotherapy than with systemic chemotherapy alone (34.3% vs 3.5%).

The investigators were also interested in understanding the variables possibly associated with a poor prognosis. They used a Cox proportional hazard model to identify male sex, therapeutic performance status, baseline hepatobiliary disease, and multifocal disease as independent factors associated with a poor prognosis. These factors ultimately elicited a hazard ratio of 0.27 for HAIP chemotherapy.

However, the investigators noted, “HAIP chemotherapy is currently offered in only about 60 centers worldwide. It is a complex treatment requiring close collaboration of a multidisciplinary team.”

Disclosure: For full disclosures of the study authors, visit springer.com.

Annals of Surgical Oncology

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