September 2022, Vol 3, No 3

Patients with advanced biliary tract cancers (BTCs) have a poor prognosis despite systemic chemotherapy. Gemcitabine/cisplatin (GemCis) is the standard first-line systemic therapy for BTCs; however, median overall survival was only 11.7 months.
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For patients with localized intrahepatic cholangiocarcinoma (iCCA), surgical resection holds curative potential for only 30% to 35% of patients due to its high rate of recurrence.
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Although gemcitabine plus platinum/fluorouracil combinations are the standard first-line treatment for advanced biliary tract cancers (BTCs), the overall outcomes are suboptimal.
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Results of the randomized, double-blind, global, phase 3 TOPAZ-1 trial demonstrated that the first-line chemoimmunotherapy regimen of the PD-L1 inhibitor durvalumab plus gemcitabine/cisplatin (GemCis; median follow-up, 16.8 months) significantly improved overall survival (OS) versus placebo plus GemCis (median follow-up, 15.9 months) in patients with advanced biliary tract cancers (BTCs).1
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The randomized, double-blind, global, phase 3 TOPAZ-1 trial demonstrated that the first-line PD-L1 inhibitor durvalumab plus gemcitabine/cisplatin (GemCis; median follow-up, 16.8 months) as first-line treatment significantly improved overall survival (OS) versus placebo plus GemCis (median follow-up, 15.9 months) in patients with advanced biliary tract cancers (BTCs).1
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Tumor-related liver failure (TRLF) is the most common cause of death in patients with metastatic intrahepatic cholangiocarcinoma (iCCA), accounting for up to 72% of deaths in patients treated with systemic therapy alone.1
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Primary analysis of the pivotal, single-arm, phase 2 FOENIX-CCA2 study demonstrated that the FGFR1-4 inhibitor futibatinib as second-line treatment yielded durable objective responses in patients with intrahepatic cholangiocarcinoma (iCCA) harboring FGFR2 fusion/rearrangements.
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