{Reference Type}: Journal Article
{Title}: Insights for clinical management from the real-life data of the centralized West of Scotland biliary cancer clinic.
{Author}: Zanuso V;Nash T;Casolino R;Armstrong G;Pallise O;Milne J;Braconi C;
{Journal}: BMC Cancer
{Volume}: 24
{Issue}: 1
{Year}: 2024 May 16
{Factor}: 4.638
{DOI}: 10.1186/s12885-024-12279-6
{Abstract}: <B>BACKGROUND: </B>With the increasing of novel therapeutics for the treatment of Biliary Tract Cancers (BTC), and the need to assess their socio-economic impacts for national licence approvals, it is as important as ever to have real-life data in national populations.<BR><B>RESULTS: </B>We performed an audit of the first 2 year-activity (Sep 2019-Sep 2021) of the centralized West-of-Scotland-BTC clinic. 122 patients accessed the service, including 68% with cholangiocarcinoma (CCA), 27% with gallbladder cancer (GBC), and 5% with ampulla of Vater carcinoma with biliary phenotype (AVC). Median age at diagnosis was 66 (28-84), with 30% of newly diagnosed patients being younger than 60 years-old. Thirty-five cases (29%) underwent surgery, followed by adjuvant-chemotherapy in 66%. 60% had recurrent disease (80% with distant relapse). Sixty-four patients (58%) started first-line Systemic-AntiCancer-Treatment (SACT). Of these, 37% received second line SACT, the majority of which had iCCA and GBC. Thirty-% of those who progressed received third line SACT.<BR><B>CONCLUSIONS: </B>About 30% of BTC were eligible for curative surgery. Fifty-eight and twenty% of the overall cohort of advanced BTC patients received first and second line SACT. Our data suggest that reflex genomic profiling may not be cost-effective until molecularly driven strategies are limited to second line setting.