Supported by an Independent Educational Grant from · 2019-09-19 · PATIENTS WITH ADVANCED BILIARY...
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Supported by an Independent Educational Grant from
Transcript of Supported by an Independent Educational Grant from · 2019-09-19 · PATIENTS WITH ADVANCED BILIARY...
Supported by an Independent Educational Grant from
MEETING SUMMARY
AASLD 2016, BOSTON USANOVEMBER 11TH TO 15TH 2016
DR. MOHAMED BOUATTOUR
HÔPITAL UNIVERSITAIRE BEAUJON, PARIS, FRANCE
NON-HCC HEPATIC MALIGNANCIES
T RA N S L AT I N G T H E A B C- 0 2 T R I A L I N TO DA I LY P RACT I C E : O U TCO M E O F PA L L I AT I V E T R E AT M E N T I N PAT I E N T S W I T H A DVA N C E D B I L I A RY T RACT CA N C E R
T R E AT E D W I T H G E M C I TA B I N E A N D C I S P L AT I N
MARCIA GASPERSZ ET AL
Centers: Rotterdam, Amsterdam, Zwolle, Breda, Hoorn, Den Bosch, Arnhem, Nijmegen, Hilversum,
Alkmaar, Apeldoorn (NETHERLANDS)
4* Valle J. et al. New Eng J Med 2010
AIMS
Gemcitabine and cisplatin is the standard of care in patients with advanced biliary tract cancer based on the ABC-02 trial*
To evaluate this chemotherapy regimen in clinical practice
5* PS: performance status, GFR: Glomerular filtration rate
METHODS
2010-2015
208 patients included
Inclusion criteria ABC-02 trial
PS: 0-2
Bilirubin ≤ 1.5 ULN
AST/ALT ≤ 5 ULN
Creatinin ≤ 1.5 ULN and GFR ≥ 45 ml/min
Group 1N = 71
Group 2N = 61
Group 3N = 65
• Patients received chemotherapy
• Met the criteria of the ABC-02 trial
• Patients received chemotherapy
• Did not meet the criteria of ABC-02 trial
Best supportive care without
chemotherapy
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MAIN RESULTS
Overall survival Progression free survivalGroup 1 = 9.7 months (95%CI: 7.1 -12.3 ) Group 2 = 9.4 months (95%CI: 7.2 - 11.6 ) Group 3 = 7.6 months (95%CI: 5.0 -10.2 ) p = 0.729 (group 1 versus 2) p = 0.011 (group 1 and 2 versus 3 )
Group 1 = 6.0 months (95%CI: 4.6- 7.4) Group 2 = 4.6 months (95%CI: 3.3- 5.9) (p=0.789)
Toxicities were similar between Groups 1 and 2
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CONCLUSION
First line treatment with gemcitabin and cisplatin appearssafe and efficient in routine use for patients with advancedbiliary tract cancer
SURVEILLANCE FOR HEPATOBILIARY CANCER IN PRIMARY SCLEROSING
CHOLANGITIS
NAVINE NASSER-GHODSI ET AL
Centers: Phoenix Amarillo, Rochester, Sacramento, Philadelphia, UNITED STATES
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AIM
The utility of surveillance program by imaging in patients with Primary Sclerosing Cholangitis (PSC) to detect biliary tract cancer and its impact on the outcome
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METHODS
1992-2012
Surveillance program: annual imaging (US, CT, or MR)
serum CA 19-9
Diagnosis of biliary tract cancer histopathologically confirmed
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MAIN RESULTS
Biliary tract cancer (n=31)
Surveillance program group
(n=9)
No surveillance program group
(n=22)
Surveillance group No surveillance group p
5-year survival rate 65% 51% 0.5
Cancer-related deaths 33% 41% 0.5
Liver transplantation 67% 55% 0.42
Patients with PSC (n=763)
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CONCLUSION
Surveillance program in PSC patients seems to have a positive impact on outcome of patients
Larger studies are needed to confirm these results
A COMPARISON OF PROGNOSTIC SCHEMES FOR PERIHILARCHOLANGIOCARCINOMA
STEFAN BUETTNER ET AL
Centers: Rotterdam, NETHERLANDS – Baltimore, Atlanta, Stanford, Nashville, Missouri, Madison, Louisville Winston-Salem, Columbus, New York,
UNITED STATES - Verona, ITALY
14* American Joint Committee on Cancer: AJCC
AIMS
Limitation of the AJCC* staging system for perihilarcholangiocarcinoma (PHC)
Validation of a proposed nomogram
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METHODS
1998-2014
407 patients resected for PHC
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MAIN RESULTS (1)
Nomogram based on: age, lymphovascular invasion, perineural invasion and lymph node metastases
42.2
55.6
45.9
57.963.1
70.8
45.7
57.1
0
10
20
30
40
50
60
70
80
3 year mortality 5 year mortality
Stage I Stage II Stage III Stage IV
Proposed nomogram Overall survival by AJCC stage
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MAIN RESULTS (2)
Nomogram based on: age, lymphovascular invasion, perineural invasion and lymph node metastases
18.824.8
51
65.763.7
77.676.5
83.4
0
10
20
30
40
50
60
70
80
90
3 year mortality 5 year mortality
Stage I Stage II Stage III Stage IV
Proposed nomogram Overall survival by proposed nomogram stage
C-Index AJCC 0.570Proposed nomogram 0.682
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CONCLUSION
This nomogram seems to better predict survival than the AJCC staging system in patients with PHC
It might be a more useful tool for clinical decision-making and prognostic stratification
Dr. Antoine Lacombe Pharm D, MBAPhone: +41 79 529 42 [email protected]
HCC CONNECTBodenackerstrasse 174103 Bottmingen SWITZERLAND
Dr. Froukje SosefMDPhone: +31 6 2324 [email protected]
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