title: Efficacy of a sequential treatment strategy with GEMOX-based followed by FOLFIRI-based chemotherapy in advanced biliary tract cancers.
abstract: BACKGROUND
  Gemcitabine (GEM)-platinum chemotherapy stands as first-line therapy for patients with recurrent/advanced biliary tract cancer (BTC), yielding progression-free survival (PFS) of 3.4-6.4 months. No standard second-line chemotherapy after GEM-platinum failure exists and data on survival benefit remain limited.
  
  
  METHODS
  We retrospectively reviewed patients with recurrent/advanced BTC who received gemcitabine-oxaliplatin (GEMOX)-based chemotherapy followed by 5-fluorouracil-irinotecan (FOLFIRI)-based chemotherapy to evaluate the efficacy of the sequential treatment strategy. Overall survival (OS) and PFS were calculated by Kaplan-Meier method.
  
  
  RESULTS
  Fifty-two patients were analyzed, 21 (40%) had intrahepatic, 14 (27%) had hilar/extrahepatic, and 17 (33%) had gallbladder cancer. Median age was 64 years (range 38-79 years). Prior curative intent resection of the primary tumor was performed in 23 (44.2%) patients and GEMOX adjuvant chemotherapy was given in 12 (23.1%) patients. After a median follow-up of 36.3 months, 47 (90.4%) patients completed the treatment strategy. First-sequence GEMOX and second sequence FOLFIRI achieved 4.8 months and 3.2 months median PFS, respectively. The global OS for the sequential chemotherapy was 21.9 months. The sequence of FOLFIRI resulted in a median OS of 8.4 months.
  
  
  CONCLUSIONS
  The sequence of GEMOX-FOLFIRI is a potential treatment strategy for patients with recurrent/advanced BTC.
authors.affiliation: a Department of Medical Oncology , Beaujon University Hospital, Assistance Publique-Hôpitaux De Paris (AP-HP) , Clichy , France.
authors.forename: Sihem
authors.initials: S
authors.lastname: Sebbagh
authors.affiliation: b Department of Medical Oncology , Saint-Antoine Hospital, Assistance Publique-Hôpitaux De Paris (AP-HP) , Paris , France.
authors.forename: Julia
authors.initials: J
authors.lastname: Roux
authors.affiliation: a Department of Medical Oncology , Beaujon University Hospital, Assistance Publique-Hôpitaux De Paris (AP-HP) , Clichy , France.
authors.forename: Chantal
authors.initials: C
authors.lastname: Dreyer
authors.affiliation: a Department of Medical Oncology , Beaujon University Hospital, Assistance Publique-Hôpitaux De Paris (AP-HP) , Clichy , France.
authors.forename: Cindy
authors.initials: C
authors.lastname: Neuzillet
authors.affiliation: a Department of Medical Oncology , Beaujon University Hospital, Assistance Publique-Hôpitaux De Paris (AP-HP) , Clichy , France.
authors.forename: Armand
authors.initials: A
authors.lastname: de Gramont
authors.affiliation: a Department of Medical Oncology , Beaujon University Hospital, Assistance Publique-Hôpitaux De Paris (AP-HP) , Clichy , France.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Orbegoso
authors.affiliation: c Department of Gastroenterology and Pancreatology , Beaujon University Hospital, Assistance Publique-Hôpitaux De Paris (AP-HP) , Clichy , France.
authors.forename: Olivia
authors.initials: O
authors.lastname: Hentic
authors.affiliation: c Department of Gastroenterology and Pancreatology , Beaujon University Hospital, Assistance Publique-Hôpitaux De Paris (AP-HP) , Clichy , France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Hammel
authors.affiliation: d Institut Hospitalier Franco-Britannique , Levallois-Perret , France.
authors.forename: Aimery
authors.initials: A
authors.lastname: de Gramont
authors.affiliation: a Department of Medical Oncology , Beaujon University Hospital, Assistance Publique-Hôpitaux De Paris (AP-HP) , Clichy , France.
authors.forename: Eric
authors.initials: E
authors.lastname: Raymond
authors.affiliation: b Department of Medical Oncology , Saint-Antoine Hospital, Assistance Publique-Hôpitaux De Paris (AP-HP) , Paris , France.
authors.forename: Thierry
authors.initials: T
authors.lastname: André
authors.affiliation: d Institut Hospitalier Franco-Britannique , Levallois-Perret , France.
authors.forename: Benoist
authors.initials: B
authors.lastname: Chibaudel
authors.affiliation: a Department of Medical Oncology , Beaujon University Hospital, Assistance Publique-Hôpitaux De Paris (AP-HP) , Clichy , France.
authors.forename: Sandrine
authors.initials: S
authors.lastname: Faivre
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001661:Biliary Tract Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D002166:Camptothecin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D002277:Carcinoma / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D002986:Clinical Trials as Topic; D003841:Deoxycytidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D018572:Disease-Free Survival; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D002955:Leucovorin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D009944:Organoplatinum Compounds / Q000627:therapeutic use; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D009944:Organoplatinum Compounds; D003841:Deoxycytidine; D002955:Leucovorin; D005472:Fluorouracil; D002166:Camptothecin