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ESMO 2023: Does Location of Extrahepatic Cholangiocarcinoma Affect Chemotherapy Outcomes?

By: Julia Fiederlein Cipriano, MS
Posted: Monday, October 30, 2023

Patients with advanced extrahepatic cholangiocarcinoma seem to experience comparable outcomes, regardless of tumor location, based on the results of a post hoc analysis of the Advanced Biliary tract Cancer (ABC)-01, -02, and -03 studies presented during the European Society for Medical Oncology (ESMO) Congress 2023 (Abstract 94MO). However, Angela Lamarca, MD, PhD, MSc, of Fundacion Jimenez Diaz University Hospital, Madrid, and colleagues noted that the overall survival outcomes, in particular, were less favorable than those historically reported for individuals with intrahepatic disease.

The investigators identified 179 patients with extrahepatic cholangiocarcinoma (distal: n = 107; hilar: n = 72). Of this population, 117 received first-line treatment with cisplatin plus gemcitabine and were thus eligible for analysis. The majority of patients (n = 82; 70.1%) had metastatic disease at the time of recruitment.

The objective radiologic response rate was 23.9% in the overall analysis population, 27.9% in patients with distal disease, and 18.4% in those with hilar disease. The median durations of progression-free survival were 8.4, 8.3, and 8.4 months, respectively; the median durations of overall survival were 12.8, 14.3, and 12.2 months. Patients with locally advanced extrahepatic cholangiocarcinoma were found to experience prolonged median durations of both progression-free (13.1 months) and overall (17.4 months) survival.

A multivariable analysis demonstrated worse overall survival outcomes for patients in the overall analysis population who had an Eastern Cooperative Oncology Group performance status of 2 (vs 0: hazard ratio [HR] = 45.877) and a high baseline CA-125 expression level (HR = 1.0007; P = .017) when adjusted for other prognostic factors identified in the univariate analysis (ie, stage and CA 19.9). According to the investigators, these associations remained significant after adjusting for the site of extrahepatic cholangiocarcinoma.

“Outcomes with first-line cisplatin plus gemcitabine and immunotherapy should also be explored,” the investigators concluded.

Disclosure: For full disclosures of the study authors, visit

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