title: Nab-paclitaxel as alternative treatment regimen in advanced cholangiocellular carcinoma.
abstract: BACKGROUND
  Advanced cholangiocellular carcinoma has a poor prognosis with limited therapeutic options. Nab-paclitaxel has recently been described to be beneficial in metastatic pancreatic cancer improving overall and progression free survival (PFS). The potential antitumor activity of nab-paclitaxel in cholangiocellular carcinoma is hitherto unknown.
  
  
  METHODS
  We retrospectively analyzed an institutional cholangiocellular carcinoma registry to determine the potential biological activity of nab-paclitaxel in advanced intrahepatic cholangiocellular carcinoma. Disease control rate (DCR), PFS and overall survival (OS) upon nab-paclitaxel based treatment, after failure of platinum-containing first-line combination chemotherapy, was assessed.
  
  
  RESULTS
  Twelve patients were identified. Five of 12 patients (42%) received nab-paclitaxel as second line, and 7 patients (56%) as third-line treatment. The objective DCR with nab-paclitaxel was 83% (10/12 patients). One patient had a complete remission (CR), two patients had a partial remission (PR) and 7 patients had stable disease (SD). Disease was rated progressive in two patients. In all 12 patients receiving nab-paclitaxel the median time to progression was 6 months (range, 2.1-19.5 months). Median OS after initiation of nab-paclitaxel treatment was 9 months (2.1-28.4 months). The median time of survival after diagnosis of advanced disease was 21.5 months, whereby 3 patients were alive at the date of censoring (04/01/2015).
  
  
  CONCLUSIONS
  This is the first report suggesting substantial antitumor activity of nab-paclitaxel in advanced cholangiocellular carcinoma. In this small series, nab-paclitaxel based salvage chemotherapy appears to have a biological activity by controlling the disease and positively affecting survival. Randomized trials in this disease entity and subgroup of patients are urged.
authors: Department of Medicine I, Comprehensive Cancer Center, Medical University Vienna, 1090 Vienna, Austria ;
authors: Matthias
authors: M
authors: Unseld
authors: Department of Medicine I, Comprehensive Cancer Center, Medical University Vienna, 1090 Vienna, Austria ;
authors: Werner
authors: W
authors: Scheithauer
authors: Department of Medicine I, Comprehensive Cancer Center, Medical University Vienna, 1090 Vienna, Austria ;
authors: Roman
authors: R
authors: Weigl
authors: Department of Medicine I, Comprehensive Cancer Center, Medical University Vienna, 1090 Vienna, Austria ;
authors: Gabriela
authors: G
authors: Kornek
authors: Department of Medicine I, Comprehensive Cancer Center, Medical University Vienna, 1090 Vienna, Austria ;
authors: Nadja
authors: N
authors: Stranzl
authors: Department of Medicine I, Comprehensive Cancer Center, Medical University Vienna, 1090 Vienna, Austria ;
authors: Daniela
authors: D
authors: Bianconi
authors: Institute for Energy Systems and Thermodynamics, Vienna University of Technology, Vienna, Austria.
authors: Georg
authors: G
authors: Brunauer
authors: Department of Medicine I, Comprehensive Cancer Center, Medical University Vienna, 1090 Vienna, Austria ;
authors: Guenther
authors: G
authors: Steger
authors: Department of Medicine I, Comprehensive Cancer Center, Medical University Vienna, 1090 Vienna, Austria ;
authors: Christoph C
authors: CC
authors: Zielinski
authors: Department of Medicine I, Comprehensive Cancer Center, Medical University Vienna, 1090 Vienna, Austria ;
authors: Gerald W
authors: GW
authors: Prager
keywords: Cholangiocellular carcinoma; anti-cancer therapy; chemotherapy; nab-paclitaxel; second-line treatment