Evidence map›Paper›PMID 42407195›Full record

ArticleESMO open2026

Cisplatin-gemcitabine-durvalumab reintroduction in advanced biliary tract cancer: a multinational real-world analysis.

S Camera, A Vogel, M Rimini, M Ikeda, O Abidoye, J Lucchetti, L Antonuzzo, J W Kim, F Nichetti, A Saborowski and 65 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in ESMO open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

75 authors.

S CameraMedical Oncology Department, IRCCS San Raffaele Hospital, Milan, Italy.
A VogelDepartment of Gastroenterology, Hepatology, Infectious Disease and Endocrinology, Hannover Medical School, Hannover, Germany; Long Family Chair in Liver Cancer Research, Division of Gastroenterology and Hepatology, Toronto General Hospital, Medical Oncology, Princess Margaret Cancer Centre, Schwartz Reisman Liver Research Centre, Toronto, Canada.
M RiminiMedical Oncology Department, IRCCS San Raffaele Hospital, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy.
M IkedaDepartment of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, Kashiwa, Japan.
O AbidoyeDepartment of Internal Medicine, Mayo Clinic, Phoenix, USA.
J LucchettiFondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy.
L AntonuzzoClinical Oncology Unit, Careggi University Hospital, Florence, Italy; Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
J W KimDivision of Hematology/Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Gyeonggi-do, Republic of Korea.
F NichettiOncology 1 Unit, Department of Medical Oncology, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy.
A SaborowskiDepartment of Gastroenterology, Hepatology, Infectious Disease and Endocrinology, Hannover Medical School, Hannover, Germany.
T PressianiMedical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
C VivaldiUnit of Medical Oncology 2, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy; Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
I G RapposelliDepartment of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy.
F PeetersDigestive Oncology, University Hospitals Leuven, Leuven, Belgium.
C BraconiUniversity of Glasgow (School of Cancer Sciences), Beatson West of Scotland Centre, CRUK Scotland Centre, Glasgow, UK.
D J PinatoDepartment of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, UK; Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy.
E TamburiniDepartment of Oncology and Palliative Care, Cardinale G. Panico, Tricase City Hospital, Tricase, Italy.
C PircherDepartment of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
S TamberiSanta Maria Delle Croci Hospital, AUSL Romagna, Ravenna, Italy; Department of DIMEC, University of Bologna, Bologna, Italy.
F CastetUpper Gastrointestinal and Endocrine Tumor Unit, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron University Hospital, Barcelona, Spain.
M VerricoUOC Oncologia A, Department of Hematology, Oncology and Dermatology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
A ParisiClinica Oncologica e Centro Regionale di Genetica Oncologica, Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria delle Marche, Ancona, Italy.
N CoutoDigestive Unit, Champalimaud Clinical Centre, Champalimaud Research Centre, Lisbon, Portugal.
H J ChonDivision of Medical Oncology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea.
A MartirenaDepartment of Medical Oncology, OncoHealth Institute, Fundacion Jimenez Diaz University Hospital, Madrid, Spain.
A LamarcaDepartment of Medical Oncology, OncoHealth Institute, Fundacion Jimenez Diaz University Hospital, Madrid, Spain; HealthResearch Institute, Fundacion Jimenez Diaz University Hospital (IIS-FJD), Madrid, Spain; Universidad Autonoma de Madrid (UAM), Madrid, Spain.
M LandriscinaMedical Oncology and Biomedical Therapy, Policlinico Riuniti, Foggia, Italy.
F FinkelmeierMedical Clinic 1, University Hospital, Goethe-University Frankfurt, Frankfurt am Main, Germany.
E OnedaDipartimento di Oncologia Medica, Fondazione Poliambulanza, Brescia, Italy.
A AvalloneClinical Experimental Abdominal Oncology Unit, Istituto Nazionale Tumori-IRCCS Fondazione G. Pascale, Naples, Italy.
E Dell'AquilaIRCCS Istituto Nazionale Tumori Regina Elena, Roma, Italy.
L PerkhoferInternal Medicine 1, University Hospital Ulm, Ulm, Germany; Institute of Molecular Oncology and Stem Cell Biology, Ulm University Hospital, Ulm, Germany.
I H KimDivision of Oncology, Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
V FormicaOncologia Medica, Dipartimento di Medicina dei Sistemi, Università di Tor Vergata, Roma, Italy.
C M de Sousa PintoDepartment of Medical Oncology, Unidade Local de Saude do Algarve (ULSAlg), Faro, Portugal.
I GarajovaMedical Oncology Unit, University Hospital of Parma, Parma, Korea.
B KangDivision of Medical Oncology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea.
S CoralloMedical Oncology Unit, IRCCS Policlinico San Matteo, Department of Internal Medicine, Pavia, Italy.
E FenocchioMedical Oncology, Candiolo Cancer Institute, FPO - IRCCS, Candiolo (TO), Candiolo, Italy.
G FarineaDepartment of Oncology, University of Turin, San Luigi Hospital, Orbassano, Turin, Italy.
A PastorinoMedical Oncology, IRCCS Ospedale Policlinico San Martino, Genova, Italy.
A DianaOncology Unit, Ospedale del Mare, Napoli, Italy.
Y ChanghoonASAN Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
M SchirripaMedical Oncology Unit, Department of Oncology and Hematology, Belcolle Hospital, Viterbo, Italy.
M G RodriquenzOncology Unit, Fondazione IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Italy.
M ScartozziMedical Oncology, University and University Hospital of Cagliari, Cagliari, Italy.
L ZumsteinGI Oncology Unit and Familial Cancer Unit, Oncology Department, Hospital Universitario 12 de Octubre, Madrid, Spain.
M GhidiniFondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy.
G W PragerDepartment of Medicine I, Clinical Division of Oncology, Medical University Vienna, Austria.
G AprileDepartment of Medical Oncology, University Hospital of Udine, Udine, Italy.
G P SpinelliUOC Oncologia Territoriale, Polo Pontino, La Sapienza Università Di Roma, Latina, Italy.
S Yung-YehNational Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan; Department of Oncology, National Cheng Kung University Hospital, College of Medicine, Tainan, Taiwan.
S L ChanDepartment of Clinical Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
E WarmingtonDepartment of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, UK; Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy.
A LancianeseClinica Oncologica e Centro Regionale di Genetica Oncologica, Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria delle Marche, Ancona, Italy.
T SatakeDepartment of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, Kashiwa, Japan.
T Bekaii-SaabDepartment of Internal Medicine, Mayo Clinic, Phoenix, USA.
G GiordanoMedical Oncology and Biomedical Therapy, Policlinico Riuniti, Foggia, Italy.
D LavacchiClinical Oncology Unit, Careggi University Hospital, Florence, Italy; Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
L PasseriMedical Oncology Department, IRCCS San Raffaele Hospital, Milan, Italy.
M FerraraMedical Oncology Department, IRCCS San Raffaele Hospital, Milan, Italy.
F RossariMedical Oncology Department, IRCCS San Raffaele Hospital, Milan, Italy.
F Lo PrinziOperative Research Unit of Medical Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, Roma, Italy.
M KangDivision of Hematology/Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Gyeonggi-do, Republic of Korea.
A A PreteDepartment of Oncology and Palliative Care, Cardinale G. Panico, Tricase City Hospital, Tricase, Italy.
S BozzarelliMedical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
M PersanoMedical Oncology Department, IRCCS San Raffaele Hospital, Milan, Italy.
G MasiUnit of Medical Oncology 2, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy; Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
R BalsanoMedical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
M NigerDepartment of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
S LonardiOncology 1 Unit, Department of Medical Oncology, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy.
F SalaniUnit of Medical Oncology 2, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy; Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
L FornaroUnit of Medical Oncology 2, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
L RimassaMedical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy. Electronic address: lorenza.rimassa@hunimed.eu.
A Casadei-GardiniMedical Oncology Department, IRCCS San Raffaele Hospital, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy. Electronic address: casadeigardini@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTreatment options for advanced biliary tract cancers (BTCs) progressing after first-line chemoimmunotherapy remain limited. Whether platinum-based chemotherapy reintroduction can restore disease control is unknown. This study evaluates cisplatin-gemcitabine-durvalumab (CGD) reintroduction in patients with advanced BTC progressing during durvalumab maintenance.

methodsA multinational cohort of patients with BTC received first-line CGD followed by durvalumab maintenance. Those progressing during maintenance and treated with CGD reintroduction or FOLFOX/XELOX were analyzed. Primary endpoints were overall survival (OS) and progression-free survival (PFS) in the CGD reintroduction group; secondary endpoints included survival outcomes from maintenance and second-line initiation, overall response rate, and disease control rate.

resultsAmong 1258 patients treated with first-line CGD, 475 received durvalumab maintenance. After disease progression during maintenance (n = 309, 65.1%), 31 patients (6.5%) underwent CGD reintroduction, while 114 (24%) received FOLFOX/XELOX. Baseline characteristics were comparable between groups, except for bilirubin levels. After a median follow-up of 22.6 months [95% confidence interval (CI) 20.0-25.1], median OS was not reached in the reintroduction cohort, while median PFS was 13.3 months (95% CI 9.7-15.8) from first-line initiation. From durvalumab maintenance start, median OS remained not reached and median PFS was 7.1 months (95% CI 4.8-11.3). Following reintroduction, median OS and PFS were 10.5 months (95% CI 8.0-10.5) and 9.0 months (95% CI 5.5-10.2). Compared with FOLFOX/XELOX, CGD reintroduction was associated with significantly improved OS [hazard ratio (HR) 0.47; P = 0.006] and PFS (HR 0.44; P < 0.0001) from first-line therapy start, as well as improved PFS from second-line treatment start (HR 0.60; P = 0.027). These findings were confirmed after multivariable and inverse probability of treatment weighting adjustment. Response outcomes were comparable between groups.

conclusionsThis is the first study evaluating CGD reintroduction in patients with BTC progressing during durvalumab maintenance. Although the retrospective design does not allow definitive conclusions, our findings suggest potential benefit in selected patients.

Indexed as

Antibodies, MonoclonalAntineoplastic Combined Chemotherapy ProtocolsBiliary Tract NeoplasmsCisplatinDeoxycytidineAgedFemaleGemcitabineHumansMaleMiddle AgedProgression-Free SurvivalAntibodies, MonoclonalCisplatinDeoxycytidinedurvalumabGemcitabinebiliary tract cancerchemoimmunotherapycholangiocarcinomadurvalumab maintenanceplatinum reintroductionreal-world evidence

Identifiers

PMID42407195
PMCPMC13355813

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