What is your preferred second line of treatment after progression on cisplatin/gemcitabine for advanced or metastatic cholangiocarcinoma?

Topics: Gastrointestinal Cancers • Medical Oncology • Liver and Pancreas Tumors

A number of phase 2 trials support various combinations (e.g. gem/ox, cape/cis, cape/ox, 5-FU based) -- how do you decide either between these regimens or others?

Answer from: Medical Oncologist at Community Practice

Cholangiocarcinoma is one of the most exciting GI tumors to treat because there are a high proportion of actionable molecular alterations: MSI, IDH1, FGF, HER-2. Then you add a small chance of RET and TRK - that's a lot of options. Agreed that the other are still in experimental stage, but I try to ...

Comments

Medical Oncologist at UT Southwestern Medical Center
Thanks Dr Beg!

Medical Oncologist at National Comprehensive Cancer Network
Agree that FOLFIRI also remains an attractive opti...

Answer from: Medical Oncologist at Academic Institution

After progression on the front-line standard of gemcitabine and cisplatin (ABC-02, Valle et al. NEJM 2010), there is not an established second-line standard of care. There are several small prospective studies as well as some retrospective data that are indeed conflicting regarding the true efficacy...

Answer from: Medical Oncologist at Community Practice

FOLFOX based on the results of the ABC-06 trial: Randomized Phase III of FOLFOX vs active symptoms control in those previously treated with cisplatin and gemictabine in metastatic biliary cancer (ASCO 2019).

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