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Benefit of second-line systemic chemotherapy for advanced biliary tract cancer: A propensity score analysis.

ABSTRACT: Whether 2^nd-line-chemotherapy (2LCTX)?+?best-supportive-care (BSC) benefits patients with advanced biliary tract cancer (aBTC) more than BSC alone is unclear. We therefore conducted a propensity-score-based comparative effectiveness analysis of overall survival (OS) outcomes in 80 patients with metastatic, recurrent, or inoperable aBTC, of whom 38 (48%) were treated with BSC?+?2LCTX and 42 (52%) with BSC alone. After a median follow-up of 14.8 months and 49 deaths, the crude 6-, 12-, and 18-month Kaplan-Meier OS estimates were 77%, 53% and 23% in the BSC?+?2LCTX group, and 29%, 21%, and 14% in patients in the BSC group (p?=?0.0003; Hazard ratio (HR)?=?0.36, 95%CI:0.20-0.64, p?=?0.001). An inverse-probability-of-treatment-weighted (IPTW) analysis was conducted to rigorously account for the higher prevalence of favorable prognostic variables in the 2LCTX?+?BSC group. After IPTW-weighting, the favorable association between 2LCTX and OS prevailed (adjusted HR?=?0.40, 95%CI: 0.17-0.95, p?=?0.037). IPTW-weighted 6-, 12-, and 18-month OS estimates were 77%, 58% and 33% in the BSC?+?2LCTX group, and 39%, 28% and 22% in the BSC group (p?=?0.037). Moreover, the benefit of 2LCTX was consistent across several clinically-relevant subgroups. Within the limitations of an observational study, these findings support the concept that 2LCTX?+?BSC is associated with an OS benefit over BSC alone in aBTC.

SUBMITTER: Moik F

PROVIDER: S-EPMC6447553 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature

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Benefit of second-line systemic chemotherapy for advanced biliary tract cancer: A propensity score analysis.

Moik Florian F Riedl Jakob M JM Winder Thomas T Terbuch Angelika A Rossmann Christopher H CH Szkandera Joanna J Bauernhofer Thomas T Kasparek Anne-Katrin AK Schaberl-Moser Renate R Reicher Andreas A Prinz Felix F Pichler Martin M Stöger Herbert H Stotz Michael M Gerger Armin A Posch Florian F

Scientific reports 20190403 1

Whether 2<sup>nd</sup>-line-chemotherapy (2LCTX) + best-supportive-care (BSC) benefits patients with advanced biliary tract cancer (aBTC) more than BSC alone is unclear. We therefore conducted a propensity-score-based comparative effectiveness analysis of overall survival (OS) outcomes in 80 patients with metastatic, recurrent, or inoperable aBTC, of whom 38 (48%) were treated with BSC + 2LCTX and 42 (52%) with BSC alone. After a median follow-up of 14.8 months and 49 deaths, the crude 6-, 12-, ...[more]

PMID: 30944390

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Benefit of second-line systemic chemotherapy for advanced biliary tract cancer: A propensity score analysis.

Publications

Benefit of second-line systemic chemotherapy for advanced biliary tract cancer: A propensity score analysis.

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