Cargando…

A Novel Combination of Bevacizumab with Chemotherapy Improves Therapeutic Effects for Advanced Biliary Tract Cancer: A Retrospective, Observational Study

SIMPLE SUMMARY: Systemic therapies for advanced biliarty tract cancers (BTC) are limited. The combination of gemcitabine with cisplatin (GC) has been the standard first-line treatment for advanced BTC from 2010 until now. In order to improve therapeutic effect, especially response rate, we added a n...

Descripción completa

Detalles Bibliográficos
Autores principales: Pei, Sung-Nan, Liao, Chun-Kai, Chen, Yaw-Sen, Tseng, Cheng-Hao, Hung, Chao-Ming, Chiu, Chong-Chi, Hsieh, Meng-Che, Tsai, Yu-Fen, Liao, Hsiu-Yun, Liu, Wei-Ching, Rau, Kun-Ming
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8345065/
https://www.ncbi.nlm.nih.gov/pubmed/34359732
http://dx.doi.org/10.3390/cancers13153831
_version_ 1783734539919556608
author Pei, Sung-Nan
Liao, Chun-Kai
Chen, Yaw-Sen
Tseng, Cheng-Hao
Hung, Chao-Ming
Chiu, Chong-Chi
Hsieh, Meng-Che
Tsai, Yu-Fen
Liao, Hsiu-Yun
Liu, Wei-Ching
Rau, Kun-Ming
author_facet Pei, Sung-Nan
Liao, Chun-Kai
Chen, Yaw-Sen
Tseng, Cheng-Hao
Hung, Chao-Ming
Chiu, Chong-Chi
Hsieh, Meng-Che
Tsai, Yu-Fen
Liao, Hsiu-Yun
Liu, Wei-Ching
Rau, Kun-Ming
author_sort Pei, Sung-Nan
collection PubMed
description SIMPLE SUMMARY: Systemic therapies for advanced biliarty tract cancers (BTC) are limited. The combination of gemcitabine with cisplatin (GC) has been the standard first-line treatment for advanced BTC from 2010 until now. In order to improve therapeutic effect, especially response rate, we added a novel schedule and dosage of bevacizumab to standard GC regimen. In our real world date, we found this regimen could increase the overall response rate to 50.0%, and side effects were managable. For patients with advanced BTC, especially whose tumors need rapid response to treatment, our regimen can provide an alternative choice. ABSTRACT: Background: Biliary tract cancer (BTC) is a heterogenous collection of biliary tract cancer at different primary sites, and the prognosis of advanced BTC is dismal. Systemic chemotherapy with gemcitabine and cisplatin (GC) has been the reference regimen since 2010. How to improve therapeutic effects of GC regimen is an urgent mission at present. Methods: Bevacizumab with a reduced dosage and modified schedule (10 mg/Kg/triweekly, 1 day before GS at the first 2 cycles) was combined with standard GC for patients with advanced BTC. Tumor response was assessed using Response Evaluation Criteria in Solid Tumors version 1.1 every 2 months. Kaplan–Meier curves were estimated for time-to-treatment failure (TTF), progression-free survival (PFS) and overall survival (OS). Result: A total of thirty cases of advanced BTC accepted this treatment, and the overall response rate (ORR) was 50.0%, and the disease control rate was 80.0% for all patients. The median TTF was 5.8 months, the median PFS was 8.4 months, and the median OS was 13.6 months. Most responses were noted at the first evaluation. Adverse effects (AEs) were mostly tolerable. Conclusions: After modifying the schedule, adding bevacizumab to a traditional GC regimen could increase the ORR with a shorter time-to-response, a better PFS and OS than GC alone but without the addition of AE. This regimen can be applied to patients with advanced BTC, especially those who are with a big tumor burden and who need a rapid response.
format Online
Article
Text
id pubmed-8345065
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-83450652021-08-07 A Novel Combination of Bevacizumab with Chemotherapy Improves Therapeutic Effects for Advanced Biliary Tract Cancer: A Retrospective, Observational Study Pei, Sung-Nan Liao, Chun-Kai Chen, Yaw-Sen Tseng, Cheng-Hao Hung, Chao-Ming Chiu, Chong-Chi Hsieh, Meng-Che Tsai, Yu-Fen Liao, Hsiu-Yun Liu, Wei-Ching Rau, Kun-Ming Cancers (Basel) Article SIMPLE SUMMARY: Systemic therapies for advanced biliarty tract cancers (BTC) are limited. The combination of gemcitabine with cisplatin (GC) has been the standard first-line treatment for advanced BTC from 2010 until now. In order to improve therapeutic effect, especially response rate, we added a novel schedule and dosage of bevacizumab to standard GC regimen. In our real world date, we found this regimen could increase the overall response rate to 50.0%, and side effects were managable. For patients with advanced BTC, especially whose tumors need rapid response to treatment, our regimen can provide an alternative choice. ABSTRACT: Background: Biliary tract cancer (BTC) is a heterogenous collection of biliary tract cancer at different primary sites, and the prognosis of advanced BTC is dismal. Systemic chemotherapy with gemcitabine and cisplatin (GC) has been the reference regimen since 2010. How to improve therapeutic effects of GC regimen is an urgent mission at present. Methods: Bevacizumab with a reduced dosage and modified schedule (10 mg/Kg/triweekly, 1 day before GS at the first 2 cycles) was combined with standard GC for patients with advanced BTC. Tumor response was assessed using Response Evaluation Criteria in Solid Tumors version 1.1 every 2 months. Kaplan–Meier curves were estimated for time-to-treatment failure (TTF), progression-free survival (PFS) and overall survival (OS). Result: A total of thirty cases of advanced BTC accepted this treatment, and the overall response rate (ORR) was 50.0%, and the disease control rate was 80.0% for all patients. The median TTF was 5.8 months, the median PFS was 8.4 months, and the median OS was 13.6 months. Most responses were noted at the first evaluation. Adverse effects (AEs) were mostly tolerable. Conclusions: After modifying the schedule, adding bevacizumab to a traditional GC regimen could increase the ORR with a shorter time-to-response, a better PFS and OS than GC alone but without the addition of AE. This regimen can be applied to patients with advanced BTC, especially those who are with a big tumor burden and who need a rapid response. MDPI 2021-07-29 /pmc/articles/PMC8345065/ /pubmed/34359732 http://dx.doi.org/10.3390/cancers13153831 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Pei, Sung-Nan
Liao, Chun-Kai
Chen, Yaw-Sen
Tseng, Cheng-Hao
Hung, Chao-Ming
Chiu, Chong-Chi
Hsieh, Meng-Che
Tsai, Yu-Fen
Liao, Hsiu-Yun
Liu, Wei-Ching
Rau, Kun-Ming
A Novel Combination of Bevacizumab with Chemotherapy Improves Therapeutic Effects for Advanced Biliary Tract Cancer: A Retrospective, Observational Study
title A Novel Combination of Bevacizumab with Chemotherapy Improves Therapeutic Effects for Advanced Biliary Tract Cancer: A Retrospective, Observational Study
title_full A Novel Combination of Bevacizumab with Chemotherapy Improves Therapeutic Effects for Advanced Biliary Tract Cancer: A Retrospective, Observational Study
title_fullStr A Novel Combination of Bevacizumab with Chemotherapy Improves Therapeutic Effects for Advanced Biliary Tract Cancer: A Retrospective, Observational Study
title_full_unstemmed A Novel Combination of Bevacizumab with Chemotherapy Improves Therapeutic Effects for Advanced Biliary Tract Cancer: A Retrospective, Observational Study
title_short A Novel Combination of Bevacizumab with Chemotherapy Improves Therapeutic Effects for Advanced Biliary Tract Cancer: A Retrospective, Observational Study
title_sort novel combination of bevacizumab with chemotherapy improves therapeutic effects for advanced biliary tract cancer: a retrospective, observational study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8345065/
https://www.ncbi.nlm.nih.gov/pubmed/34359732
http://dx.doi.org/10.3390/cancers13153831
work_keys_str_mv AT peisungnan anovelcombinationofbevacizumabwithchemotherapyimprovestherapeuticeffectsforadvancedbiliarytractcanceraretrospectiveobservationalstudy
AT liaochunkai anovelcombinationofbevacizumabwithchemotherapyimprovestherapeuticeffectsforadvancedbiliarytractcanceraretrospectiveobservationalstudy
AT chenyawsen anovelcombinationofbevacizumabwithchemotherapyimprovestherapeuticeffectsforadvancedbiliarytractcanceraretrospectiveobservationalstudy
AT tsengchenghao anovelcombinationofbevacizumabwithchemotherapyimprovestherapeuticeffectsforadvancedbiliarytractcanceraretrospectiveobservationalstudy
AT hungchaoming anovelcombinationofbevacizumabwithchemotherapyimprovestherapeuticeffectsforadvancedbiliarytractcanceraretrospectiveobservationalstudy
AT chiuchongchi anovelcombinationofbevacizumabwithchemotherapyimprovestherapeuticeffectsforadvancedbiliarytractcanceraretrospectiveobservationalstudy
AT hsiehmengche anovelcombinationofbevacizumabwithchemotherapyimprovestherapeuticeffectsforadvancedbiliarytractcanceraretrospectiveobservationalstudy
AT tsaiyufen anovelcombinationofbevacizumabwithchemotherapyimprovestherapeuticeffectsforadvancedbiliarytractcanceraretrospectiveobservationalstudy
AT liaohsiuyun anovelcombinationofbevacizumabwithchemotherapyimprovestherapeuticeffectsforadvancedbiliarytractcanceraretrospectiveobservationalstudy
AT liuweiching anovelcombinationofbevacizumabwithchemotherapyimprovestherapeuticeffectsforadvancedbiliarytractcanceraretrospectiveobservationalstudy
AT raukunming anovelcombinationofbevacizumabwithchemotherapyimprovestherapeuticeffectsforadvancedbiliarytractcanceraretrospectiveobservationalstudy
AT peisungnan novelcombinationofbevacizumabwithchemotherapyimprovestherapeuticeffectsforadvancedbiliarytractcanceraretrospectiveobservationalstudy
AT liaochunkai novelcombinationofbevacizumabwithchemotherapyimprovestherapeuticeffectsforadvancedbiliarytractcanceraretrospectiveobservationalstudy
AT chenyawsen novelcombinationofbevacizumabwithchemotherapyimprovestherapeuticeffectsforadvancedbiliarytractcanceraretrospectiveobservationalstudy
AT tsengchenghao novelcombinationofbevacizumabwithchemotherapyimprovestherapeuticeffectsforadvancedbiliarytractcanceraretrospectiveobservationalstudy
AT hungchaoming novelcombinationofbevacizumabwithchemotherapyimprovestherapeuticeffectsforadvancedbiliarytractcanceraretrospectiveobservationalstudy
AT chiuchongchi novelcombinationofbevacizumabwithchemotherapyimprovestherapeuticeffectsforadvancedbiliarytractcanceraretrospectiveobservationalstudy
AT hsiehmengche novelcombinationofbevacizumabwithchemotherapyimprovestherapeuticeffectsforadvancedbiliarytractcanceraretrospectiveobservationalstudy
AT tsaiyufen novelcombinationofbevacizumabwithchemotherapyimprovestherapeuticeffectsforadvancedbiliarytractcanceraretrospectiveobservationalstudy
AT liaohsiuyun novelcombinationofbevacizumabwithchemotherapyimprovestherapeuticeffectsforadvancedbiliarytractcanceraretrospectiveobservationalstudy
AT liuweiching novelcombinationofbevacizumabwithchemotherapyimprovestherapeuticeffectsforadvancedbiliarytractcanceraretrospectiveobservationalstudy
AT raukunming novelcombinationofbevacizumabwithchemotherapyimprovestherapeuticeffectsforadvancedbiliarytractcanceraretrospectiveobservationalstudy