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Benefit of second-line systemic chemotherapy for advanced biliary tract cancer: A propensity score analysis
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 me...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6447553/ https://www.ncbi.nlm.nih.gov/pubmed/30944390 http://dx.doi.org/10.1038/s41598-019-42069-1 |
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author | Moik, Florian Riedl, Jakob M. Winder, Thomas Terbuch, Angelika Rossmann, Christopher H. Szkandera, Joanna Bauernhofer, Thomas Kasparek, Anne-Katrin Schaberl-Moser, Renate Reicher, Andreas Prinz, Felix Pichler, Martin Stöger, Herbert Stotz, Michael Gerger, Armin Posch, Florian |
author_facet | Moik, Florian Riedl, Jakob M. Winder, Thomas Terbuch, Angelika Rossmann, Christopher H. Szkandera, Joanna Bauernhofer, Thomas Kasparek, Anne-Katrin Schaberl-Moser, Renate Reicher, Andreas Prinz, Felix Pichler, Martin Stöger, Herbert Stotz, Michael Gerger, Armin Posch, Florian |
author_sort | Moik, Florian |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-6447553 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-64475532019-04-10 Benefit of second-line systemic chemotherapy for advanced biliary tract cancer: A propensity score analysis Moik, Florian Riedl, Jakob M. Winder, Thomas Terbuch, Angelika Rossmann, Christopher H. Szkandera, Joanna Bauernhofer, Thomas Kasparek, Anne-Katrin Schaberl-Moser, Renate Reicher, Andreas Prinz, Felix Pichler, Martin Stöger, Herbert Stotz, Michael Gerger, Armin Posch, Florian Sci Rep Article 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. Nature Publishing Group UK 2019-04-03 /pmc/articles/PMC6447553/ /pubmed/30944390 http://dx.doi.org/10.1038/s41598-019-42069-1 Text en © The Author(s) 2019 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Article Moik, Florian Riedl, Jakob M. Winder, Thomas Terbuch, Angelika Rossmann, Christopher H. Szkandera, Joanna Bauernhofer, Thomas Kasparek, Anne-Katrin Schaberl-Moser, Renate Reicher, Andreas Prinz, Felix Pichler, Martin Stöger, Herbert Stotz, Michael Gerger, Armin Posch, Florian Benefit of second-line systemic chemotherapy for advanced biliary tract cancer: A propensity score analysis |
title | Benefit of second-line systemic chemotherapy for advanced biliary tract cancer: A propensity score analysis |
title_full | Benefit of second-line systemic chemotherapy for advanced biliary tract cancer: A propensity score analysis |
title_fullStr | Benefit of second-line systemic chemotherapy for advanced biliary tract cancer: A propensity score analysis |
title_full_unstemmed | Benefit of second-line systemic chemotherapy for advanced biliary tract cancer: A propensity score analysis |
title_short | Benefit of second-line systemic chemotherapy for advanced biliary tract cancer: A propensity score analysis |
title_sort | benefit of second-line systemic chemotherapy for advanced biliary tract cancer: a propensity score analysis |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6447553/ https://www.ncbi.nlm.nih.gov/pubmed/30944390 http://dx.doi.org/10.1038/s41598-019-42069-1 |
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