العلاج من الخط الأول لسرطان المرارة المتقدم أو النقيلي في المرضى ذوي حالة أداء ECOG 0–1

DOI: 10.1016/j.annonc.2022.10.506

• Cisplatin–gemcitabine is recommended as SoC in the first-line setting for patients with a PS of 0-1.
• ChT is the current SoC for first-line treatment of advanced BTC; OS is improved when compared with best supportive care alone and the cisplatin–gemcitabine doublet demonstrated an OS benefit over gemcitabine mono-therapy in the UK ABC-02 study and the Japanese BT22 study.
• The combination of cisplatin–gemcitabine with durvalumab should be considered in first-line BTC.
• Oxaliplatin may be substituted for cisplatin when renal function is of concern.
• During systemic and locoregional therapy for advanced disease, follow-up should be conducted at a frequency of 8-12 weeks to allow best assessment of treatment efficacy, or as required for disease-related complications.
• In addition to imaging by CT or MRI, CA 19-9 or carcinoembryonic antigen (CEA) levels may be used to monitor the course of the disease if one or both are known to be secreted.