摘要
The incidence of biliary tract cancer(BTC)(1),including gallbladder cancer(GBC)(2),is increasing.Potentially curative surgery is possible in only approximately 20%,and adjuvant capecitabine,versus observation after resection,has been reported to improve survival in a prespecified sensitivity and per-protocol analyses of the phase 3 randomised trial BILCAP(capecitabine compared with observation in resected BTC)(adjusting for minimisation factors,nodal status,grade,and gender)(3,4).The prognosis for patients with advanced BTC is poor;the median overall survival(OS)for patients receiving standard of care cisplatin/gemcitabine in the first-line setting was 11.7 months in the Advanced Biliary Cancer-02(ABC-02)study(5).There has been no alteration in the established choice of first-line systemic treatment for advanced BTC for over a decade.However,a recent press release announced that the phase 3 randomised study of durvalumab in combination with cisplatin/gemcitabine versus placebo with cisplatin/gemcitabine as a first-line treatment for patients with advanced BTC(TOPAZ-1)had met its primary endpoint of OS at the interim analysis;detailed results are awaited(NCT03875235).
