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CC BY 4.0 · Indian J Med Paediatr Oncol
DOI: 10.1055/s-0044-1787750
Original Article

Treatment Outcomes in Advanced Biliary Tract Cancers: Single Institution Retrospective Analysis

Nikhil Pathi
1   Department of Medical Oncology, Basavatarakam Indo-American Cancer Hospital & Research Institute, Hyderabad, Telangana, India
,
Senthil J. Rajappa
1   Department of Medical Oncology, Basavatarakam Indo-American Cancer Hospital & Research Institute, Hyderabad, Telangana, India
,
Santa Ayyagari
1   Department of Medical Oncology, Basavatarakam Indo-American Cancer Hospital & Research Institute, Hyderabad, Telangana, India
,
M V. T. Krishna Mohan
1   Department of Medical Oncology, Basavatarakam Indo-American Cancer Hospital & Research Institute, Hyderabad, Telangana, India
,
Pavan Kumar
1   Department of Medical Oncology, Basavatarakam Indo-American Cancer Hospital & Research Institute, Hyderabad, Telangana, India
,
Rakesh Pinninti
1   Department of Medical Oncology, Basavatarakam Indo-American Cancer Hospital & Research Institute, Hyderabad, Telangana, India
,
Pallavi Ladda
1   Department of Medical Oncology, Basavatarakam Indo-American Cancer Hospital & Research Institute, Hyderabad, Telangana, India
,
Sanath Kandem
1   Department of Medical Oncology, Basavatarakam Indo-American Cancer Hospital & Research Institute, Hyderabad, Telangana, India
,
Rohan Tewani
1   Department of Medical Oncology, Basavatarakam Indo-American Cancer Hospital & Research Institute, Hyderabad, Telangana, India
,
Kinjal Shah
1   Department of Medical Oncology, Basavatarakam Indo-American Cancer Hospital & Research Institute, Hyderabad, Telangana, India
,
Kripa Bajaj
1   Department of Medical Oncology, Basavatarakam Indo-American Cancer Hospital & Research Institute, Hyderabad, Telangana, India
,
Sree Rama Krishnaiah
1   Department of Medical Oncology, Basavatarakam Indo-American Cancer Hospital & Research Institute, Hyderabad, Telangana, India
,
Divya Gandrala
1   Department of Medical Oncology, Basavatarakam Indo-American Cancer Hospital & Research Institute, Hyderabad, Telangana, India
› Author Affiliations Source of Funding None.
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Abstract

Purpose Biliary tract cancers (BTCs), particularly gallbladder cancers (GBCs), are prevalent in India. Yet there are limited data on treatment outcomes. To bridge this gap, we performed an analysis of advanced BTC treatment outcomes at our institute, seeking to offer insights into real-world scenario.

Materials and Methods This is a retrospective study comprising advanced BTC patients treated at our institute from January 2015 to March 2023. We assessed demographics, treatment approaches, progression-free survival (PFS), overall survival (OS), and associated toxicities.

Results Of the 411 patients analyzed, the majority were GBC (67.3%, n = 277), while the rest were cholangiocarcinoma (CCA) (32.6%, n = 134). The median age of study population was 56 years. Palliative chemotherapy was administered in 85% (n = 349) of all patients. Gemcitabine–cisplatin doublet was the most commonly used chemotherapy regimen (80.2%, n = 280). Platinum doublets yielded higher response rates compared with single-agent/nonplatinum chemotherapy (60 vs. 30%, n = 133). The median PFS was 4 months. The median OS was 8 months with platinum doublets and 5 months with single-agent/nonplatinum chemotherapy (hazard ratio [HR]: 0.60, 95% confidence interval: [CI] 0.43–0.84, p = 0.0001). OS was no different based on the type of platinum agent used. Patients receiving multiple lines of treatment lived longer compared with those who received single line only (14 vs. 6 months, respectively, HR: 0.36, 95% CI: 0.28–0.45, p < 0.0001). Significant prognostic factors for OS were treatment with chemotherapy, platinum doublets, platinum exposure in first line, and treatment beyond first line. Grade 3 or 4 adverse effects seen were anemia (13.9%, n = 36), vomiting (4.2%, n = 11), diarrhea (3.4%, n = 9), thrombocytopenia (3.4%, n = 9), and febrile neutropenia (3.1%, n = 8).

Conclusion This analysis confirms that chemotherapy is beneficial for advanced BTC. Platinum-based doublets are more effective than single agents. There is no significant difference between cisplatin and oxaliplatin. Patients who received multiple lines of treatment had better OS.

Keywords

advanced biliary tract cancers - first-line chemotherapy - outcomes

Ethical Considerations

This study received ethical approval from the Basavatarakam Indo-American Cancer Hospital & Research Institute, Institutional Ethics Committee Board (BIACH&RI IEC, Reg. no.: ECR/7/Inst/AP/2013/RR-20, protocol no.: IEC/2023/12, date: January 1, 2023). All procedures performed were by the ethical standards of the institution and/or national research committee. They were also in concordance with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards apart from Good Clinical Practice guidelines for the International Conference on Harmonization.


Patient Consent

Patient consent was not taken as it was a retrospective study.


Authors' Contribution

N.P. contributed to conceptualization, design, definition of intellectual content, literature search, clinical studies, data acquisition, data analysis, statistical analysis, manuscript preparation, manuscript editing, and manuscript review. S.J.R. contributed to conceptualization, design, definition of intellectual content, clinical studies, data analysis, statistical analysis, manuscript preparation, manuscript editing, and manuscript review. S., M.V.T.K.M., P.K., R.P., P.L., S.K., R.T, K.S., and S.R.K. contributed to data acquisition, manuscript preparation, and manuscript review. K.B. contributed to data acquisition and manuscript review. D.G. contributed to data analysis, statistical analysis, and manuscript review.




Publication History

Article published online:
25 June 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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