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Adjuvant Gemcitabine-Oxaliplatin (GeMOX) after Curative Surgery in High-risk Patients with Cholangiocarcinoma

Authors :
Bernard Paule
Paola Andreani
Marie-Pierre Bralet
Catherine Guettier
René Adam
Denis Castaing
Daniel Azoulay
Source :
Clinical Medicine Insights: Oncology, Vol 3 (2009)
Publication Year :
2009
Publisher :
SAGE Publishing, 2009.

Abstract

Background There is no standard adjuvant chemotherapy to prevent recurrent cholangiocarcinoma (CCA), a rare cancer with poor prognosis. We assessed the efficacy and safety of GEMOX on intrahepatic and hilar CCA with high-risk factors after curative surgery. Patients and Methods Twenty two patients (mean age: 57 years old) with CCA received 6 cycles of GEMOX: gemcitabine 1,000 mg/m 2 on day 1 and oxaliplatin 85 mg/m 2 on day 2, q3w after a curative surgery. Results All patients completed 6 cycles of GEMOX. EGFR membranous expression was present in 20 CCA. The 5-year survival rate was 56% (CI 95%: 25.7–85.4); 2-year disease free survival rate was 28% (CI 95%: 3.4–52.6). Median time to progression was 15 months. The rate of recurrence after surgery and chemotherapy was 63% (14/22). Two patients died of disease progression. Twelve patients received cetuximab/GEMOX at the time of relapse. Six died after 12 months (9–48 months), three are still alive suggesting a clinical applicability of EGFR inhibitors in CCA. Conclusion Adjuvant chemotherapy with GEMOX alone seems ineffective in intrahepatic and hilar CCA with a high risk of relapse. Additional studies including targeted therapies to circumvent such poor chemosensitivity are needed.

Details

Language :
English
ISSN :
11795549
Volume :
3
Database :
Directory of Open Access Journals
Journal :
Clinical Medicine Insights: Oncology
Publication Type :
Academic Journal
Accession number :
edsdoj.94d483fb5b5245d78964b06b7aff94a6
Document Type :
article
Full Text :
https://doi.org/10.4137/CMO.S3360