New Standard Treatment For Advanced Biliary Tract Cancer: Cisplatin Plus Gemcitabine

Good news for patients with advanced biliarystable disease) was observed in 81.4% of patients
tract cancer.  Combination of cisplatin andin the combination group and 71.8% in the
gemcitabine (Gemzar) have been shown to be angemcitabine-only group (P = .049). A complete
effective treatment option for patients with locallyresponse was observed in 1 patient from each
advanced or metastatic biliary tract cancer.  treatment
In developed nations, biliary tract cancer is Â 
uncommon, but the incidence is increasing.  MostThe median overall survival was 11.7 months in
patients, when diagnosed, are already atthe combination group and 8.1 months in the
advanced stage of the disease.  Althoughgemcitabine-only group, representing a 36%
advanced biliary tract cancer responds toreduction in mortality. In addition, median
chemotherapy, there is no standard 1st lineprogression-free survival was 8.0 months in the
palliative regimen. combination group and 5.0 months in the
In the April 8 issue of the New England Journal ofgemcitabine-only group (P < .001).
Medicine, British researchers reported that cisplatinSimilar Adverse Events
plus gemcitabine was associated with a significantAdverse events were similar in the 2 groups. A
survival advantage, compared with gemcitabinehigher, but not significant, incidence of neutropenia
alone. Toxicity was not substantially increased inwas observed in the combination group and the
patients who received the combination regimen. infection rates were similar between the 2 groups.
The trial was conducted at 37 centers in thePatients in the gemcitabine-only group had
United Kingdom. A total of 410 patients withsignificantly worse liver function (27.1%) than
locally advanced or metastatic cholangiocarcinoma,those in the combination group (16.7%) and the
gallbladder cancer, or ampullary cancer wereauthors speculated the better liver function was a
randomized to receive either 1) cisplatin followedreflection of the better disease control in the
by gemcitabine or 2) gemcitabine alone for up tocombination group.
24 weeks. N Engl J Med. 2010;362:1273-1281, 1335-1337.
Tumor control (complete or partial response orPlease visit us at healthreason.