Titre :

First-line chemotherapy with selective internal radiation therapy for intrahepatic cholangiocarcinoma
The French ACABi GERCOR PRONOBIL cohort

Auteur(s) :

Adamus, Nicolas [Auteur]
Cooperator Multidisciplinary Oncology Group [GERCOR]
Centre Hospitalier Universitaire [CHU Grenoble] [CHUGA]
Edeline, Julien [Auteur]
Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC (UMR INSERM 1098) [RIGHT]
Oncogenesis, Stress, Signaling [OSS]
Henriques, Julie [Auteur]
Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC (UMR INSERM 1098) [RIGHT]
Fares, Nadim [Auteur]
Centre Hospitalier Universitaire de Toulouse [CHU Toulouse]
Lecomte, Thierry [Auteur]
Niche, Nutrition, Cancer et métabolisme oxydatif [N2Cox]
Hôpital Trousseau
Turpin, Anthony [Auteur]
Cooperator Multidisciplinary Oncology Group [GERCOR]
Hétérogénéité, Plasticité et Résistance aux Thérapies des Cancers = Cancer Heterogeneity, Plasticity and Resistance to Therapies - UMR 9020 - U 1277 [CANTHER]
Vernerey, Dewi [Auteur]
Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC (UMR INSERM 1098) [RIGHT]
Vincens, Mathilde [Auteur]
Chanez, Brice [Auteur]
Institut Paoli-Calmettes [IPC]
Centre de Recherche en Cancérologie de Marseille [CRCM]
Tougeron, David [Auteur]
Centre hospitalier universitaire de Poitiers = Poitiers University Hospital [CHU de Poitiers [La Milétrie]]
Tournigand, Christophe [Auteur]
Institut Mondor de Recherche Biomédicale [IMRB]
CHU Henri Mondor [Créteil]
Assenat, Eric [Auteur]
Institut de Génétique Moléculaire de Montpellier [IGMM]
Delaye, Matthieu [Auteur]
Biologie Cellulaire et Cancer
Hôpital Raymond Poincaré (Garches) [GHU AP-HP Université Paris-Saclay]
Manfredi, Sylvain [Auteur]
Lipides - Nutrition - Cancer [Dijon - U1231] [LNC]
Bouché, Olivier [Auteur]
Hôpital universitaire Robert Debré [Reims] [CHU Reims]
Williet, Nicolas [Auteur]
Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] [CHU ST-E]
Vienot, Angélique [Auteur]
Centre Hospitalier Régional Universitaire de Besançon [CHRU Besançon]
Blaise, Lorraine [Auteur]
Centre de Recherche des Cordeliers [CRC (UMR_S_1138 / U1138)]
Mas, Léo [Auteur]
CHU Pitié-Salpêtrière [AP-HP]
Neuzillet, Cindy [Auteur]
Biologie Cellulaire et Cancer
Hôpital Raymond Poincaré (Garches) [GHU AP-HP Université Paris-Saclay]
Boilève, Alice [Auteur]
Hôpital Raymond Poincaré (Garches) [GHU AP-HP Université Paris-Saclay]
Roth, Gael S. [Auteur correspondant]
Centre Hospitalier Universitaire [CHU Grenoble] [CHUGA]

Titre de la revue :

JHEP Reports Innovation in Hepatology

Pagination :

101279

Éditeur :

Elsevier

Date de publication :

2025-02

Mot(s)-clé(s) en anglais :

cholangiocarcinoma
biliary tract cancer
SIRT
radioembolization
CISGEM
GEMOX

Discipline(s) HAL :

Sciences du Vivant [q-bio]/Cancer

Résumé en anglais : [en]

Background and Aims: Selective internal radiation therapy (SIRT) is a promising option for liver-only unresectable intrahepatic cholangiocarcinoma (iCCA). The Real-SIRTCCA study retrospectively assessed the benefit of ...
Lire la suite >Background and Aims: Selective internal radiation therapy (SIRT) is a promising option for liver-only unresectable intrahepatic cholangiocarcinoma (iCCA). The Real-SIRTCCA study retrospectively assessed the benefit of adding SIRT to chemotherapy in this setting within the French nationwide observational cohort ACABi-GERCOR-PRONOBIL. Methods: Inclusion criteria were advanced iCCA with limited or no extrahepatic disease, treated with first-line gemcitabine plus platinum chemotherapy +/- concurrent SIRT. All patients treated with chemotherapy and concurrent SIRT were included. To ensure groups' similarity, a rigorous selection was applied to the chemo-only group, with exclusion of patients with liver involvement >50% and extrahepatic metastases. The primary outcome was progression-free survival (PFS). Secondary outcomes were overall survival (OS), objective response rate (ORR) and tumor resection rate. Propensity score and inverse probability of treatment weighting (IPTW) propensity approaches were used to address confounding factors between groups. Results: Between July 2007 and December 2023, 277 patients met the Real-SIRTCCA inclusion criteria, with 88 in the chemoSIRT group and 189 in chemo-only group. Chemo-SIRT was associated with longer PFS (median = 10.8 vs. 5.5 months, hazard ratio [HR] 0.54, 95% CI 0.41-0.71, p <0.0001), a trend for longer OS (median = 22.5 vs. 15.1 months, HR 0.76, 95% CI 0.571.01), higher ORR (58.3% vs. 28.5%, odds ratio [OR] 3.51, 95% CI 2.03-6.09, p <0.0001), and resection rate (18.7% vs. 8.8%, p = 0.0279) compared to chemo-alone. After IPTW, the superiority of chemo-SIRT was confirmed with better PFS (HR 0.55, 95% CI 0.45-0.66, p <0,0001), OS (HR 0.70, 95% CI 0.58-0.85, p = 0.0004), ORR (OR 3.17, 95% CI 2.18-4.49, p <0.0001) and resection rate (OR 2.94, 95% CI 1.71-5.03, p <0.0001). Conclusions: Adding SIRT to first-line chemotherapy significantly improved survival outcomes, ORR, and secondary tumor resection rates in locally advanced iCCA. Prospective randomized data are needed to confirm these results. Clinical trial number: NCT04935853. (c) 2024 The Author(s). Published by Elsevier B.V. on behalf of European Association for the Study of the Liver (EASL). This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).Lire moins >

Langue :

Anglais

Comité de lecture :

Oui

Audience :

Internationale

Vulgarisation :

Non

Collections :

• Cancer Heterogeneity, Plasticity and Resistance to Therapies (CANTHER) - UMR 9020 - UMR 1277

Source :

Harvested from HAL