Soonchunhyang Med Sci.  2015 Dec;21(2):75-81. 10.0000/sms.2015.21.2.75.

Second-Line Chemotherapy in Advanced Biliary Tract Cancer: A Retrospective Analysis

• Kim HJ
• Yun J
• Kim HJ
• Kim KH
• Kim SH
• Lee SC
• Bae SB
• Kim CK
• Lee NS
• Lee KT
• Park SK
• Won JH
• Choi HJ
• Moon JH
• Hong DS

• KMID: 2317760
• DOI: http://doi.org/10.0000/sms.2015.21.2.75

Abstract

OBJECTIVE
The evidence of 2nd line chemotherapy has not been validated. We investigated the treatment outcomes of 2nd line palliative chemotherapy in patients with biliary tract cancer (BTC) and analyzed the factors affecting response or survival.
METHODS
We retrospectively reviewed and analyzed the outcomes in advanced BTC patients who underwent 2nd line chemotherapy in Soonchunhyang Universitiy Hospitals (Bucheon, Seoul, and Cheonan).
RESULTS
From December 2004 to May 2014, 65 patients were enrolled. The median age was 56 years (range, 40 to 76 years) and the ratio of cholangiocarcinoma (intrahepatic or extrahepatic), gall bladder cancer, and ampulla of Vater cancer was 41 (63.1%):18 (27.7%):6 (9.25%). Half of the patients (33 patients, 50.8%) were treated with gemcitabine-based and 28 patients (43.1%) with 5-fluorouracil- based therapy. The response rate was 3.0% and disease control rate was 21.5% in intention-to-treat analysis. Median overall survival (OS) was 7.2 months (95% confidence interval [CI], 3.9 to 10.5 months) and median progression free survival (PFS) was 3.7 months (95% CI, 2.5 to 4.9 months). In multivariate analysis, patients with good performance status (PS) (P=0.001) and chemo-sensitive tumor to 2nd line chemotherapy (P=0.000) had longer PFS as compared to the others. In addition, patients with good PS (P=0.003), chemo-sensitive tumor to 1st line (P=0.046), and 2nd line chemotherapy (P=0.004) were good prognostic factors for OS.
CONCLUSION
The effect of 2nd line chemotherapy in advanced BTC was modest and maybe beneficial in select patients.

Keyword

Biliary tract neoplasms; Drug therapy; Salvage therapy

MeSH Terms

Ampulla of Vater
Biliary Tract Neoplasms*
Biliary Tract*
Cholangiocarcinoma
Disease-Free Survival
Drug Therapy*
Gallbladder Neoplasms
Humans
Multivariate Analysis
Retrospective Studies*
Salvage Therapy
Seoul