A Retrospective Analysis of Biliary Tract Cancer Patients Presented to the Molecular Tumor Board at the Comprehensive Cancer Center Munich

With the rising importance of precision oncology in biliary tract cancer (BTC), this analysis describes the clinical and molecular characteristics of this patients.
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A Retrospective Analysis of Biliary Tract Cancer Patients Presented to the Molecular Tumor Board at the Comprehensive Cancer Center Munich - Targeted Oncology

Background and Objective With the rising importance of precision oncology in biliary tract cancer (BTC), the aim of this retrospective single-center analysis was to describe the clinical and molecular characteristics of patients with BTC who underwent comprehensive genomic profiling (CGP) and were discussed in the CCCMunichLMU molecular tumor board (MTB). Patients and Methods In this single-center observational study, we included BTC patients with intrahepatic cholangiocarcinoma (iCCA), extrahepatic CCA (eCCA), and gallbladder cancer (GB), who had been discussed in the institutional MTB from May 29, 2017, to July 25, 2022. Patients were followed up until 31 January 2023. Data were retrospectively collected by review of medical charts, and MTB recommendation. Results In total, 153 cases were registered to the MTB with a median follow-up of 15 months. Testing was successful in 81.7% of the patients. CGP detected targetable alterations in 35.3% of our BTC patients (most commonly ARID1A/ERBB2/IDH1/PIK3CA/BRAF-mutations and FGFR2-fusions). Recommendations for molecularly guided therapy were given in 46.4%. Of those, treatment implementation of targeted therapy followed in 19.4%. In patients receiving the recommended treatment, response rate was 57% and median overall survival was 19 months (vs 8 months in the untreated cohort). The progression-free survival ratio of 1.45 suggest a clinical benefit of molecularly guided treatment. Conclusions In line with previous work, our series demonstrates feasibility and clinical utility of comprehensive genomic profiling in BTC patients. With the growing number of targeted agents with clinical activity in BTC, CGP should become standard of care in the management of this group of patients.

As targeted treatment in biliary tract cancer has experienced a phenomenal rise in the past few years. We set out to look at the real-world data at our Comprehensive Cancer Center Munich. We included patients with intrahepatic cholangiocarcinoma (iCCA), extrahepatic CCA (eCCA), and gallbladder cancer (GB), who had been discussed in our institutional molecular tumor board from 2017 to 2022. A total of 153 patients were included in this retrospective study.

Our main key points were:

Comprehensive genomic profiling (CGP) showed 35.3% of our biliary tract cancer cohort harbored a targetable alteration.

Implementation rate of all recommended targeted treatments was 19.4%, indicating the need for better translation into clinical practice.
Patients receiving targeted treatments experienced better clinical response than untreated patients. 
CGP is necessary to offer biliary tract cancer patients better care and treatment options !

To see a more detailed and further results from the study:

doi: 10.1007/s11523-023-00985-3

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Biliary Tract Cancer
Life Sciences > Health Sciences > Clinical Medicine > Diseases > Cancers > Gastrointestinal Cancer > Biliary Tract Cancer
Oncology
Life Sciences > Health Sciences > Clinical Medicine > Oncology
Molecularly targeted therapy
Life Sciences > Health Sciences > Clinical Medicine > Therapeutics > Drug Therapy > Molecularly targeted therapy