Nanoliposomal irinotecan in advanced biliary tract cancers
Mené en Allemagne sur 100 patients atteints d'un cancer des voies biliaires (âge médian : 65 ans), cet essai multicentrique de phase II évalue l'efficacité, du point de vue de la survie sans progression, et la toxicité de l'ajout de l'irinotécan liposomal à un traitement de deuxième ligne combinant fluorouracile et leucovorine après l'échec d'une chimiothérapie à base de gemcitabine
The treatment of advanced biliary tract cancers remains a challenge. In the past 15 years, however, things have finally begun to move. The combination of cisplatin, gemcitabine (CISGEM regimen), and immune checkpoint inhibitors became the first-line standard, pushing median survival beyond 1 year. 1 , 2 Advanced biliary tract cancers also entered the era of targeted therapy, opening the way to a new range of effective treatments. 3 However, apart from an actionable genetic alteration, treatment options remain limited beyond the first-line setting. The ABC-06 phase 3 trial established FOLFOX (fluorouracil, leucovorin, and oxaliplatin) as the standard second-line treatment, but with limited overall survival benefit over best supportive care alone (median 6·2 months [95% CI 5·4–7·6] vs 5·3 months [4·1–5·8], hazard ratio [HR] 0·69 [0·50–0·97]; p=0·031).