Real-world treatment patterns and challenges of patients with biliary tract cancer: retrospective chart review survey in Europe (GARNET-2).

Background: Biliary tract cancers (BTCs), a heterogeneous group of cancers arising from the biliary tract, account for ∼15% of primary liver cancers. Patients are often diagnosed with advanced disease, resulting in poor prognoses and documented 5-year survival rates of <2%. The aim of this study was to describe real-world treatment patterns and outcomes among patients with advanced BTC in France, Germany, Italy, Spain, and the UK. Patients and methods: A retrospective, physician-abstracted chart review survey was conducted between May 2018 and October 2021. Data were abstracted from medical charts of adult patients diagnosed with advanced BTC who initiated treatment with first-line (1L) systemic therapy. Patient characteristics, treatment patterns, and clinical outcomes were summarized descriptively. Results: In total, 196 physicians provided data for 792 advanced BTC patients who initiated 1L systemic therapy. Mean age was 65.7 years and most of the patients were male (62.6%). At data abstraction 56.1% were deceased. The most frequently prescribed 1L systemic treatment was cisplatin-gemcitabine (47.9%). The median 1L treatment duration was 5.3 months. Additionally, 33.5% of patients received 2L and 4.5% received 3L+ treatment. Median real-world overall survival from index date was 13.4 months, with substantial regional variation. Conclusions: This study supports extant data detailing that presentation at an advanced stage may contribute to the poor outcomes of BTC patients. There are significant implications for awareness and guideline-driven pathway changes to improve outcomes for these poorly served patients.