CCA Summit Live from ASCO 2022

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.

Although gemcitabine plus platinum/fluorouracil combinations are the standard first-line treatment for advanced biliary tract cancers (BTCs), the overall outcomes are suboptimal.

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

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

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

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.

Adjuvant capecitabine (CAP) is the current standard of care as adjuvant therapy for patients with resected cholangiocarcinoma (CCA); however, patient outcomes are still suboptimal.

At the CCA Summit during the 2021 Annual Meeting of the American Society of Clinical Oncology (ASCO), Mitesh J. Borad, MD, Associate Professor of Medicine, Mayo Clinic, Phoenix, AZ, reviewed some of the key topics presented at ASCO 2021 related to cholangiocarcinoma (CCA) and other biliary tract cancers. Before turning to the specific presentations, Dr Borad welcomed the May 28, 2021, FDA approval of infigratinib (Truseltiq) for patients with advanced or metastatic CCA and FGFR2 fusions or rearrangements. Infigratinib follows pemigatinib (Pemazyre) as the second targeted therapy now available for this patient population.