Effect of Molecular Profiling on Survival Among Patients With Biliary Tract Cancers

At the 2023 World Congress on Gastrointestinal Cancers, Leony Antoun, MD, Goustave Roussy Cancer Campus, Paris, France, discusses the impact of molecular profiling on survival among patients with advanced biliary tract cancers. In this study, patients treated with a molecular targeted agent had a better overall survival than those patients treated conventionally.

Dr Antoun concluded, “Profile your patients. If it's possible, give them the targeted agents because it is going to have a benefit on the overall survival of the treatment of these patients.”

Transcript:

Good morning. My name is Leony Antoun. I'm a medical oncologist at Gustave Roussy in Paris, in France. I am here, I'm a participant in the 2023 World Congress on Gastrointestinal Cancers to present a short abstract on the impact of molecular profiling on the overall survival of biliary tract cancer patients, especially in the advanced course.

To start with, we should say that biliary tract cancer is a rare group of cancer that is really heterogeneous, whether it was etiologically, molecularly. And it's divided into 3 major groups: intrahepatic or extrahepatic cholangiocarcinoma, and the gallbladder cancers. We know that the intrahepatic cholangiocarcinoma are the most molecularly-altered cancers, and they harbor especially the FGFR1, 2, 3, and 4 mutations and the IDH1 and 2 mutations. Whereas in the extrahepatic course and the gallbladder cancers, we see especially the HER2 amplification.

We conducted this study in order to determine whether having a molecular profile and having a specific drug or a specific molecular-targeted agent is going to increase or decrease or didn't have any impact on the overall survival of the treatment of advanced biliary tract cancers.

We conducted a retrospective monocentric study where we included patients between January 2015 and December 2021. The main objective of this study was the overall survival and the secondary objectives were the growth modulation index, which was calculated as the ratio of the time to progression of the line after the molecular profile and the previous line, and the GMI that is superior or equal to 133 was considered as significant. So, in this study, all the molecular iterations that were identified were classified using the ESCAT classification.

We started with 546 patients that were included, from whom 313 patients had a molecular profile. These patients were divided into three groups with us excluding the patient that weren't treated. And we divided the population into three groups, as I said before. The first group were the patients that had a molecular profile and an ESCAT alteration and a molecular-targeted agent. The second group were the people that had the molecular profile, had an ESCAT alteration, but were treated conventionally. And the third group were the people with molecular profile without ESCAT alteration and that were treated conventionally.

In this study, we saw that the overall survival in the group 1, which is the group of patients with targetable alteration with an adequate molecular-targeted agent, had a better overall survival from the other 2 groups. And the difference were about 6 months between the groups 2 and 3 and the group 1. And we saw also that in GMI in the group 1 of the population was in almost 50% of the patients significant, compared to 35 in group 2 and 32% in group 3.

To conclude my talk, I'm going to say that profile your patients. If it's possible, give them the targeted agents because it is going to have a benefit on the overall survival of the treatment of these patients.

I would like to end with a thank you for all the ESMO committee and especially to Professor Michel Ducreux for this opportunity to conduct this study and to be here, a part of the 2023 World Congress on Gastrointestinal Cancers. It's my first, and thank you again.

Source:

Antoun L, Deneche I, Boileve A, et al. Impact of molecular profiling on survival in patients with advanced biliary tract cancers. Presented at the 2023 World Congress on Gastrointestinal Cancers; June 28-July 1, 2023; Barcelona, Spain. Abstract SO-4.