ArticleLiver international : official journal of the International Association for the Study of the Liver2022
Pattern of progression of intrahepatic cholangiocarcinoma: Implications for second-line clinical trials.
Article in Liver international : official journal of the International Association for the Study of the Liver, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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7 citing papers in PubMed, 9 citations in OpenAlex.
- Low SVEP1 in intrahepatic cholangiocarcinoma mediates phenotype switching-driven metastasis by Jag2/Notch1/Hes5.Cell death & disease · 2025Article
- Immunotherapy change overcomes acquired resistance after chemo-immunotherapy in unresectable biliary tract cancer.Cancer immunology, immunotherapy : CII · 2025Article
- The pattern of tumor progression on first-line immune checkpoint inhibitor-based systemic therapy for Chinese advanced hepatocellular carcinoma -CLEAP 004 study.Frontiers in immunology · 2024Article
- Second-Line Chemotherapy for Intrahepatic Cholangiocarcinomas: What Is the Real Gain?Life (Basel, Switzerland) · 2023Article
- Bone Metastases from Intrahepatic Cholangiocarcinoma Confer Worse Prognosis.Current oncology (Toronto, Ont.) · 2023Article
- The efficacy and safety of lenvatinib plus transarterial chemoembolization in combination with PD-1 antibody in treatment of unresectable recurrent hepatocellular carcinoma: a case series report.Frontiers in oncology · 2023Article
- Pattern of progression of intrahepatic cholangiocarcinoma: Implications for second-line clinical trials.Liver international : official journal of the International Association for the Study of the Liver · 2022Article
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13 authors at 4 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundIntrahepatic cholangiocarcinoma (iCCA) is the second most frequent liver cancer. The overall survival of iCCA and other biliary tract cancers (BTC) remains poor. Recently, the ABC-06 trial reported the superiority of FOLFOX vs clinical observation as a second-line treatment. Still, the survival benefit was less than expected. We hypothesized that the pattern of progression of iCCA can drive post-progression survival (PPS), similar to hepatocellular carcinoma.
methodsMulticentre retrospective evaluation of consecutive iCCA patients who progressed after frontline systemic treatment with gemcitabine as monotherapy or in combination with platinum. Radiological assessment of progression was evaluated according to RECIST 1.1. The progression pattern was divided according to the presence/absence of new extrahepatic lesions (NEH).
resultsWe included 206 patients from 5 centres. The median OS was 14.1 months and its independent predictors (hazard ratio [HR], 95% confidence interval [CI]) were previous surgery 0.699 [0.509-0.961], performance status >2.445 [1.788-3.344], permanent first-line discontinuation 16.072 [5.102-50.633], registration of ascites 2.226 [1.448-3.420] or bilirubin >3 mg/dl 3.004 [1.935-4.664] during the follow-up, and disease progression 2.523 [1.261-5.050]. The appearance of NEH independently predicted OS 2.18 [1.55-3.06] in patients with radiological progression. Amongst 138 patients eligible for second-line treatment, PPS was 16.8 and 5.9 months in cases without and with NEH, respectively (P = .001). Progression owing to NEH lesions was an independent predictor of PPS 1.873 [1.333-2.662], together with performance status, time to progression to the frontline treatment, bilirubin >3 mg/dl and ascites.
conclusionsPPS of iCCA is influenced by progression pattern, with important implications for second-line trial design and analysis.
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