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Sandra and Edward Meyer Cancer Center

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Adjuvant capecitabine therapy extends survival in biliary tract cancer

Thursday, May 18, 2017

Because it it rather rare, most doctors don't deal with biliary tract, or gallbladder, cancer. And when they do come across it, they are not sure what to do, as there is no standard of care. A new study to be presented at the upcoming meeting of the ASCO Annual Meeting on June 2-6, 2017 in Chicago will suggest the use of currently available chemotherapy drug capecitabine following curative resection, following a trial of 447 patients from 44 clinical sites across the UK. 

Allyson Ocean, M.D., applauded the results and the efforts of the researchers in a article in HemOnc Today. Read the full story here.

Gastrointestinal oncologist Allyson Ocean of the Meyer Cancer CenterAllyson Ocean, M.D. "I had a patient with this exact question — what should we do after someone has surgery for their biliary cancer because, up until now, there existed no standard of care? Because we know this is such a bad cancer in terms of high recurrence rates for any stage, as oncologists, we tend to lean more toward treating, and sometimes we do that without evidence.

It is important that researchers conducted a large trial in this disease state, showing patients who take capecitabine for 6 months after their surgery had a better outcome. In a way, the results validate our usual practice of thinking these patients need to have adjuvant therapy due to the high recurrence rates. I applaud the researchers, because it is very hard to conduct such a large study in such a rare disease. Even specialty centers do not see many patients with this disease, so being able to conduct a large study like this was important.

With these 447 patients from whom researchers collected samples, there is now an extensive database of genomics where we can hopefully find information and figure out why these cancers are so difficult to treat, determine why they come back and define their resistance to treatment. We now have a library of data we can sift through in a more meaningful way.

We know biliary cancers tend to have a lot of mutations within the genome of the cancer. As we study these genomes further, patients will be eligible for studies looking at targeted therapies against the cancer, potentially leading to more patient enrollment in clinical trials. In biliary cancer, there are not a lot of clinical trials, and that is a huge issue for patients with this disease. However, now that we have this large database of genomic information, we will be able to study it and design clinical trials from it."