Gemcitabine Cisplatin and Durvalumab Experience in Advanced Biliary Tract Cancers: A Real-World, Multicentric Data From India

PURPOSEBiliary tract cancers (BTCs) are usually diagnosed in advanced stages, where treatment options are either palliative chemotherapy and/or best supportive care. The breakthrough results of the TOPAZ-1 trial demonstrated a 24% decrease in risk of death at 2 years with the addition of durvalumab...

Full description

Saved in:
Bibliographic Details
Main Authors: Vamshi Krishna Muddu, Anjali Shah, Anupa John, Abhishek Raj, Ankur Bahl, Senthil J. Rajappa, Thirumalairaj Raja, Joydeep Ghosh, Viraj Lavingia, Amish Vora, Prabhat Bhargava, Anant Ramaswamy, Arif Khan, Atul Sharma, Mehak Trikha, Aditya Dhanawat, Avinash Bonda, Indraja Siripurapu, Manoj Mahajan, Nitesh Rohatgi, Mosale Venkatesha Chandrakant, Himanshu Gujarathi, Manan Vora, Sumankumar Ankathi, Vikas S. Ostwal
Format: Article
Language:English
Published: American Society of Clinical Oncology 2024-12-01
Series:JCO Global Oncology
Online Access:https://ascopubs.org/doi/10.1200/GO.24.00216
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850174633602449408
author Vamshi Krishna Muddu
Anjali Shah
Anupa John
Abhishek Raj
Ankur Bahl
Senthil J. Rajappa
Thirumalairaj Raja
Joydeep Ghosh
Viraj Lavingia
Amish Vora
Prabhat Bhargava
Anant Ramaswamy
Arif Khan
Atul Sharma
Mehak Trikha
Aditya Dhanawat
Avinash Bonda
Indraja Siripurapu
Manoj Mahajan
Nitesh Rohatgi
Mosale Venkatesha Chandrakant
Himanshu Gujarathi
Manan Vora
Sumankumar Ankathi
Vikas S. Ostwal
author_facet Vamshi Krishna Muddu
Anjali Shah
Anupa John
Abhishek Raj
Ankur Bahl
Senthil J. Rajappa
Thirumalairaj Raja
Joydeep Ghosh
Viraj Lavingia
Amish Vora
Prabhat Bhargava
Anant Ramaswamy
Arif Khan
Atul Sharma
Mehak Trikha
Aditya Dhanawat
Avinash Bonda
Indraja Siripurapu
Manoj Mahajan
Nitesh Rohatgi
Mosale Venkatesha Chandrakant
Himanshu Gujarathi
Manan Vora
Sumankumar Ankathi
Vikas S. Ostwal
author_sort Vamshi Krishna Muddu
collection DOAJ
description PURPOSEBiliary tract cancers (BTCs) are usually diagnosed in advanced stages, where treatment options are either palliative chemotherapy and/or best supportive care. The breakthrough results of the TOPAZ-1 trial demonstrated a 24% decrease in risk of death at 2 years with the addition of durvalumab to chemotherapy.MATERIALS AND METHODSThis was a multicenter retrospective cohort study conducted across 14 institutions in India. All the patients were diagnosed with advanced BTCs. The primary objective was to assess median overall survival (mOS) with the use of durvalumab in combination with chemotherapy backbone. The patient details, treatment details, laboratory results, and outcome parameters were recorded from the prospectively collected databases.RESULTSA total of 148 patients were included with a median age of 57.5 years; 36 (24.3%) patients had borderline Eastern Cooperative Oncology Group performance status ≥2. The most common subtype was gall bladder cancer (GBC), seen in 94 patients (63.5%); 126 (85.1%) patients presented with de novo metastases. At a median follow-up of 6.8 months (95% CI, 5.9 to 7.8), the estimated mOS for the entire cohort was 12 months (95% CI, 7.8 to 16.3) and median progression-free survival was 8.2 months (95% CI, 7.1 to 9.4) with objective response achieved in 44 (29.7%) patients, and the estimated 2-year OS being 25%. Immune-related grade 3/4 adverse events were reported in 11 (7.4%) patients. In multivariate analysis, age <60 years (P = .001) and standard dose of durvalumab (P < .001) were found to have improved OS compared with age >60 years and low dose of durvalumab.CONCLUSIONTo our knowledge, these real-world data provide the first evidence in Indian context of the efficacy and safety of durvalumab plus chemotherapy in patients with advanced/metastatic BTCs especially in GBC.
format Article
id doaj-art-5e1cae9054f54403ab5431925579c484
institution OA Journals
issn 2687-8941
language English
publishDate 2024-12-01
publisher American Society of Clinical Oncology
record_format Article
series JCO Global Oncology
spelling doaj-art-5e1cae9054f54403ab5431925579c4842025-08-20T02:19:37ZengAmerican Society of Clinical OncologyJCO Global Oncology2687-89412024-12-011010.1200/GO.24.00216Gemcitabine Cisplatin and Durvalumab Experience in Advanced Biliary Tract Cancers: A Real-World, Multicentric Data From IndiaVamshi Krishna Muddu0Anjali Shah1Anupa John2Abhishek Raj3Ankur Bahl4Senthil J. Rajappa5Thirumalairaj Raja6Joydeep Ghosh7Viraj Lavingia8Amish Vora9Prabhat Bhargava10Anant Ramaswamy11Arif Khan12Atul Sharma13Mehak Trikha14Aditya Dhanawat15Avinash Bonda16Indraja Siripurapu17Manoj Mahajan18Nitesh Rohatgi19Mosale Venkatesha Chandrakant20Himanshu Gujarathi21Manan Vora22Sumankumar Ankathi23Vikas S. Ostwal24Department of Medical Oncology and Hematology, Institute of Oncology, AIG Hospitals, Hyderabad, IndiaDepartment of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai, IndiaDepartment of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai, IndiaDepartment of Medical Oncology, Sarvodaya Hospital, Faridabad, IndiaDepartment of Medical Oncology, Fortis Memorial Hospital, Gurgaon, IndiaDepartment of Medical Oncology, Basavatarakam Indo American Cancer Hospital &amp; RI, Hyderabad, IndiaDepartment of Medical Oncology, Apollo Cancer Hospital, Chennai, IndiaDepartment of Medical Oncology, Apollo Cancer Center, Kolkata, IndiaDepartment of GI Medical Oncology, Shalby Hospital, Ahmedabad, IndiaHope Cancer Centre, New Delhi, IndiaDepartment of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai, IndiaDepartment of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai, IndiaDepartment of Medical Oncology and Hematology, Institute of Oncology, AIG Hospitals, Hyderabad, IndiaDepartment of Medical Oncology, Max Superspeciality Hospital, Delhi, IndiaDepartment of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai, IndiaDepartment of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai, IndiaDepartment of Medical Oncology, AIG Hospitals, Hyderabad, IndiaDepartment of Medical Oncology, AIG Hospitals, Hyderabad, IndiaDepartment of Medical Oncology, Pacific Medical College, Udaipur, IndiaDepartment of Medical Oncology, Fortis Memorial Hospital, Gurgaon, IndiaDepartment of Medical Oncology, Narayana Superspeciality Hospital, Howrah and R N Tagore Hospital, Kolkata, IndiaDepartment of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai, IndiaDepartment of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai, IndiaDepartment of Interventional Radiology, Tata Memorial Centre, Homi Bhabha National Institute HBNI, Mumbai, IndiaDepartment of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai, IndiaPURPOSEBiliary tract cancers (BTCs) are usually diagnosed in advanced stages, where treatment options are either palliative chemotherapy and/or best supportive care. The breakthrough results of the TOPAZ-1 trial demonstrated a 24% decrease in risk of death at 2 years with the addition of durvalumab to chemotherapy.MATERIALS AND METHODSThis was a multicenter retrospective cohort study conducted across 14 institutions in India. All the patients were diagnosed with advanced BTCs. The primary objective was to assess median overall survival (mOS) with the use of durvalumab in combination with chemotherapy backbone. The patient details, treatment details, laboratory results, and outcome parameters were recorded from the prospectively collected databases.RESULTSA total of 148 patients were included with a median age of 57.5 years; 36 (24.3%) patients had borderline Eastern Cooperative Oncology Group performance status ≥2. The most common subtype was gall bladder cancer (GBC), seen in 94 patients (63.5%); 126 (85.1%) patients presented with de novo metastases. At a median follow-up of 6.8 months (95% CI, 5.9 to 7.8), the estimated mOS for the entire cohort was 12 months (95% CI, 7.8 to 16.3) and median progression-free survival was 8.2 months (95% CI, 7.1 to 9.4) with objective response achieved in 44 (29.7%) patients, and the estimated 2-year OS being 25%. Immune-related grade 3/4 adverse events were reported in 11 (7.4%) patients. In multivariate analysis, age <60 years (P = .001) and standard dose of durvalumab (P < .001) were found to have improved OS compared with age >60 years and low dose of durvalumab.CONCLUSIONTo our knowledge, these real-world data provide the first evidence in Indian context of the efficacy and safety of durvalumab plus chemotherapy in patients with advanced/metastatic BTCs especially in GBC.https://ascopubs.org/doi/10.1200/GO.24.00216
spellingShingle Vamshi Krishna Muddu
Anjali Shah
Anupa John
Abhishek Raj
Ankur Bahl
Senthil J. Rajappa
Thirumalairaj Raja
Joydeep Ghosh
Viraj Lavingia
Amish Vora
Prabhat Bhargava
Anant Ramaswamy
Arif Khan
Atul Sharma
Mehak Trikha
Aditya Dhanawat
Avinash Bonda
Indraja Siripurapu
Manoj Mahajan
Nitesh Rohatgi
Mosale Venkatesha Chandrakant
Himanshu Gujarathi
Manan Vora
Sumankumar Ankathi
Vikas S. Ostwal
Gemcitabine Cisplatin and Durvalumab Experience in Advanced Biliary Tract Cancers: A Real-World, Multicentric Data From India
JCO Global Oncology
title Gemcitabine Cisplatin and Durvalumab Experience in Advanced Biliary Tract Cancers: A Real-World, Multicentric Data From India
title_full Gemcitabine Cisplatin and Durvalumab Experience in Advanced Biliary Tract Cancers: A Real-World, Multicentric Data From India
title_fullStr Gemcitabine Cisplatin and Durvalumab Experience in Advanced Biliary Tract Cancers: A Real-World, Multicentric Data From India
title_full_unstemmed Gemcitabine Cisplatin and Durvalumab Experience in Advanced Biliary Tract Cancers: A Real-World, Multicentric Data From India
title_short Gemcitabine Cisplatin and Durvalumab Experience in Advanced Biliary Tract Cancers: A Real-World, Multicentric Data From India
title_sort gemcitabine cisplatin and durvalumab experience in advanced biliary tract cancers a real world multicentric data from india
url https://ascopubs.org/doi/10.1200/GO.24.00216
work_keys_str_mv AT vamshikrishnamuddu gemcitabinecisplatinanddurvalumabexperienceinadvancedbiliarytractcancersarealworldmulticentricdatafromindia
AT anjalishah gemcitabinecisplatinanddurvalumabexperienceinadvancedbiliarytractcancersarealworldmulticentricdatafromindia
AT anupajohn gemcitabinecisplatinanddurvalumabexperienceinadvancedbiliarytractcancersarealworldmulticentricdatafromindia
AT abhishekraj gemcitabinecisplatinanddurvalumabexperienceinadvancedbiliarytractcancersarealworldmulticentricdatafromindia
AT ankurbahl gemcitabinecisplatinanddurvalumabexperienceinadvancedbiliarytractcancersarealworldmulticentricdatafromindia
AT senthiljrajappa gemcitabinecisplatinanddurvalumabexperienceinadvancedbiliarytractcancersarealworldmulticentricdatafromindia
AT thirumalairajraja gemcitabinecisplatinanddurvalumabexperienceinadvancedbiliarytractcancersarealworldmulticentricdatafromindia
AT joydeepghosh gemcitabinecisplatinanddurvalumabexperienceinadvancedbiliarytractcancersarealworldmulticentricdatafromindia
AT virajlavingia gemcitabinecisplatinanddurvalumabexperienceinadvancedbiliarytractcancersarealworldmulticentricdatafromindia
AT amishvora gemcitabinecisplatinanddurvalumabexperienceinadvancedbiliarytractcancersarealworldmulticentricdatafromindia
AT prabhatbhargava gemcitabinecisplatinanddurvalumabexperienceinadvancedbiliarytractcancersarealworldmulticentricdatafromindia
AT anantramaswamy gemcitabinecisplatinanddurvalumabexperienceinadvancedbiliarytractcancersarealworldmulticentricdatafromindia
AT arifkhan gemcitabinecisplatinanddurvalumabexperienceinadvancedbiliarytractcancersarealworldmulticentricdatafromindia
AT atulsharma gemcitabinecisplatinanddurvalumabexperienceinadvancedbiliarytractcancersarealworldmulticentricdatafromindia
AT mehaktrikha gemcitabinecisplatinanddurvalumabexperienceinadvancedbiliarytractcancersarealworldmulticentricdatafromindia
AT adityadhanawat gemcitabinecisplatinanddurvalumabexperienceinadvancedbiliarytractcancersarealworldmulticentricdatafromindia
AT avinashbonda gemcitabinecisplatinanddurvalumabexperienceinadvancedbiliarytractcancersarealworldmulticentricdatafromindia
AT indrajasiripurapu gemcitabinecisplatinanddurvalumabexperienceinadvancedbiliarytractcancersarealworldmulticentricdatafromindia
AT manojmahajan gemcitabinecisplatinanddurvalumabexperienceinadvancedbiliarytractcancersarealworldmulticentricdatafromindia
AT niteshrohatgi gemcitabinecisplatinanddurvalumabexperienceinadvancedbiliarytractcancersarealworldmulticentricdatafromindia
AT mosalevenkateshachandrakant gemcitabinecisplatinanddurvalumabexperienceinadvancedbiliarytractcancersarealworldmulticentricdatafromindia
AT himanshugujarathi gemcitabinecisplatinanddurvalumabexperienceinadvancedbiliarytractcancersarealworldmulticentricdatafromindia
AT mananvora gemcitabinecisplatinanddurvalumabexperienceinadvancedbiliarytractcancersarealworldmulticentricdatafromindia
AT sumankumarankathi gemcitabinecisplatinanddurvalumabexperienceinadvancedbiliarytractcancersarealworldmulticentricdatafromindia
AT vikassostwal gemcitabinecisplatinanddurvalumabexperienceinadvancedbiliarytractcancersarealworldmulticentricdatafromindia