يتناول هذا البروتوكول إدارة سرطان القنوات الصفراوية عندما يكون المرض متقدماً أو غير قابل للجراحة، وعندما تكون حالة أداء المريض كافية — وهو الوضع السريري الذي يكون فيه العلاج الجهازي من الخط الأول مناسباً.
Cisplatin plus gemcitabine (CisGem) chemotherapy is recommended as the first-line treatment in patients with advanced biliary tract cancer (BTC).
CisGem chemotherapy is recommended as the first-line treatment in patients with advanced BTC.
Immunotherapy may be added to CisGem chemotherapy, if approved and available, cognisant of the magnitude of benefit and toxicities.
Use of gemcitabine alone in patients with poor performance status would be reasonable and substitution of oxaliplatin for cisplatin is reasonable in those with renal impairment.
Combination chemotherapy is recommended in patients with adequate performance status following failure of first-line chemotherapy, particularly in the absence of a targetable molecular alteration.
DOI: 10.1136/gutjnl-2023-330029
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