Avoid common mistakes on your manuscript.
Past
Patients with advanced cholangiocarcinoma had median overall survival (OS) of only 1 year with palliative gemcitabine–cisplatin in the Advanced Biliary Cancer (ABC) trials. No survivors were observed beyond 3 years.1,2 The majority of patients with unresectable intrahepatic cholangiocarcinoma (iCCA) die from progressive disease in the liver with biliary obstruction and subsequent liver failure, rather than from widespread metastatic disease.3 Hepatic arterial infusion pump (HAIP) chemotherapy has been investigated as an alternative treatment for unresectable iCCA in several studies. National Comprehensive Cancer Network (NCCN) guidelines recommend HAIP chemotherapy for advanced iCCA confined to the liver only in experienced centers or clinical trials.4 In this meta-analysis, we investigated OS after HAIP chemotherapy with floxuridine for patients with unresectable iCCA.
Present
Nine studies, including three phase II trials, had a total sample size of 478 patients without extrahepatic disease other than locoregional nodal disease, of whom 154 unique patients were included in the meta-analysis. The weighted median OS was 29.0 months, and the pooled 3-year OS was 39.5%.5 These results compare favorably with the results of systemic chemotherapy reported in the ABC trials.1,2 However, no randomized controlled trial (RCT) has been performed.
Future
More research is necessary to optimally determine the efficacy of HAIP chemotherapy for unresectable iCCA, and additional study of quality-of-life measures is recommended. An international RCT (NCT04891289) is currently investigating the additional value of HAIP chemotherapy for patients with unresectable iCCA treated with palliative gemcitabine–oxaliplatin (GemOx).
References
Valle J, Wasan H, Palmer DH, et al. Cisplatin plus gemcitabine versus gemcitabine for biliary tract cancer. N Engl J Med. 2010;362(14):1273–81.
Lamarca A, Ross P, Wasan HS, et al. Advanced intrahepatic cholangiocarcinoma: post hoc analysis of the ABC-01, -02, and -03 clinical trials. J Natl Cancer Inst. 2020;112(2):200–10.
Yamashita S, Koay EJ, Passot G, et al. Local therapy reduces the risk of liver failure and improves survival in patients with intrahepatic cholangiocarcinoma: a comprehensive analysis of 362 consecutive patients. Cancer. 2017;123(8):1354–62.
NCCN Guidelines Version 5.2021. Hepatobiliary cancers. https://www.nccn.org/professionals/physician_gls/pdf/hepatobiliary.pdf. Updated 2021. Accessed February 8, 2022.
Holster JJ, El Hassnaoui M, Franssen S, et al. Hepatic arterial infusion pump chemotherapy for unresectable intrahepatic cholangiocarcinoma: a systematic review and meta-analysis. Ann Surg Oncol. 2022. https://doi.org/10.1245/s10434-022-11439-x.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Disclosure
The authors declare no conflicts of interest and received no external funding for this research.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
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 licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence 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 licence, visit http://creativecommons.org/licenses/by/4.0/.
About this article
Cite this article
Holster, J.J., Groot Koerkamp, B. ASO Author Reflections: Usage of Hepatic Arterial Infusion Pump Chemotherapy for Unresectable Intrahepatic Cholangiocarcinoma. Ann Surg Oncol 29, 5539–5540 (2022). https://doi.org/10.1245/s10434-022-11516-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1245/s10434-022-11516-1