Clinical characteristics and outcome of patients with combined hepatocellular-cholangiocarcinoma—a European multicenter cohort

ESMO Open

article

K. Pomej¹  L. Balcar¹  K. Shmanko³  S. Welland⁴  V. Himmelsbach⁵  B. Scheiner¹  A. Mahyera¹  B. Mozayani⁷  M. Trauner¹  F. Finkelmeier⁵  A. Weinmann³  A. Vogel⁴  M. Pinter¹ 

[1] Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna;Liver Cancer ,(HCC) Study Group Vienna, Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna;Department of Internal Medicine I, University Medical Center of the Johannes Gutenberg University Mainz;Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School;Department of Gastroenterology, Hepatology and Endocrinology, University Hospital Frankfurt;Division of Cancer, Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital;Department of Pathology, Medical University of Vienna

关键词: mixed hepatocellular-cholangiocarcinoma;    hepato-cholangiocarcinoma;    sorafenib;    chemotherapy;    immunotherapy;    immune checkpoint inhibitor;   

DOI  :  10.1016/j.esmoop.2023.100783

学科分类：社会科学、人文和艺术（综合）

来源: BMJ Publishing Group

【 摘 要 】

Background There is no clear consensus on the optimal systemic treatment regimen in combined hepatocellular-cholangiocarcinoma (cHCC-CCA) patients. We describe clinical characteristics and outcome of cHCC-CCA patients, with a special focus on patients receiving palliative systemic therapy, including immune checkpoint inhibitors (ICIs).Methods In this European retrospective, multicenter study, patients with histologically proven cHCC-CCA treated at four institutions between April 2003 and June 2022 were included. In patients receiving palliative systemic therapy, outcome was compared between cytotoxic chemotherapy (CHT)- and non-cytotoxic CHT (nCHT)-treated patients.Results Of 101 patients, the majority were male (n = 70, 69%) with a mean age of 64.6 ± 10.6 years. Only type of first-line treatment was independently associated with overall survival (OS). Palliative systemic therapy was administered to 44 (44%) patients. Of those, 25 (57%) patients received CHT and 19 (43%) had nCHT (n = 16 of them sorafenib) in systemic first line. Although there was no significant difference in overall response rate (ORR; CHT versus nCHT: 8% versus 5%), disease control rate (24% versus 21%), and median progression-free survival {3.0 months [95% confidence interval (CI) 1.4-4.6 months] versus 3.2 months (95% CI 2.8-3.6 months), P = 0.725}, there was a trend towards longer median OS in the CHT group [15.5 months (95% CI 8.0-23.0 months) versus 5.3 months (95% CI 0-12.5 months), P = 0.052]. However, in multivariable analysis, type of first-line regimen (CHT versus sorafenib) was not associated with OS. ORR in patients receiving ICIs (n = 7) was 29%.Conclusions In patients with cHCC-CCA, OS, progression-free survival, ORR, and disease control rate were not significantly different between individuals receiving CHT and patients receiving nCHT. Immunotherapy may be effective in a subset of patients. Prospective studies are needed to identify optimal systemic treatment regimens in cHCC-CCA.

【 授权许可】

CC BY|CC BY-NC-ND