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Clinical Studies

Influence of cirrhosis on outcomes of patients with advanced intrahepatic cholangiocarcinoma receiving chemotherapy

British Journal of Cancer volume 129, pages 1766–1772 (2023)Cite this article

Subjects

Abstract

Background

Cirrhosis is a risk factor for intrahepatic cholangiocarcinoma (iCC). However, its exact prevalence is uncertain and its impact on the management of advanced disease is not established.

Methods

Retrospective analysis of patients treated with systemic chemotherapy for advanced iCC in the 1st-line setting at 2 tertiary cancer referral centres. Cirrhosis was diagnosed based on at least one element prior to any treatment: pathological diagnosis, baseline platelets <150 × 109/L, portal hypertension and/or dysmorphic liver on imaging.

Results

In the cohort of patients (n = 287), 82 (28.6%) had cirrhosis (45 based on pathological diagnosis). Patients with cirrhosis experienced more grade 3/4 haematologic toxicity (44% vs 22%, respectively, P = 0.001), and more grade 3/4 non-haematologic toxicity (34% vs 14%, respectively, P = 0.001) than those without. The overall survival (OS) was significantly shorter in patients with cirrhosis: median 9.1 vs 13.1 months for those without (HR = 1.56 [95% CI: 1.19–2.05]); P = 0.002), confirmed on multivariable analysis (HR = 1.48 [95% CI: 1.04–2.60]; P = 0.028).

Conclusion

Cirrhosis was relatively common in patients with advanced iCC and was associated with increased chemotherapy-induced toxicity and shorter OS. Formal assessment and consideration of cirrhosis in therapeutic management is recommended.

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Fig. 1: Description of the population.
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Fig. 5: Kaplan–Meier curves for overall survival stratified by ALBI grade.
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Data availability

Any request of data should be addressed to the corresponding author.

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Funding

This study did not receive any funding.

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Authors and Affiliations

  1. Department of Medical Oncology, Centre Eugène Marquis, Rennes, France

    Constance d’Abrigeon, Samuel Le Sourd, Héloïse Bourien, Alexandre Peinoit & Julien Edeline

  2. Division of Cancer Sciences, University of Manchester/Department of Medical Oncology, The Christie NHS Foundation, Manchester, UK

    Mairéad G. McNamara & Juan W. Valle

  3. Department of Medical Oncology, The Christie NHS Foundation, Manchester/Division of Cancer Sciences, University of Manchester, Manchester, UK

    Angela Lamarca & Richard A. Hubner

  4. Department of Gastroenterology, CHU Pontchaillou, Inserm U1242, COSS (Chemistry Oncogenesis Stress Signaling), Rennes 1 University, Rennes, France

    Astrid Lièvre

  5. Department of Hepatology, CHU Pontchaillou, Rennes, France

    Thomas Uguen

Authors
  1. Constance d’Abrigeon
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Contributions

MMN: research grant support: Servier, Ipsen and NuCana. Travel and accommodation: Bayer and Ipsen, Speaker honoraria: Advanced Accelerator Applications (UK and Ireland) Ltd., Pfizer, Ipsen, NuCana and Mylan. Advisory boards: Celgene, Ipsen, Sirtex, Baxalta, Incyte and AstraZeneca. AL: Dr Angela Lamarca has received travel and educational support from Ipsen, Pfizer, Bayer, AAA, SirtEx, Novartis, Mylan and Delcath; speaker honoraria from Merck, Pfizer, Ipsen, Incyte, AAA, QED, Servier, AstraZeneca and EISAI; advisory and consultancy honoraria from EISAI, Nutricia Ipsen, QED, Roche, Servier, Boston Scientific, Albireo Pharma, AstraZeneca, Boehringer Ingelheim, GENFIT and TransThera Biosciences; she is member of the Knowledge Network and NETConnect Initiatives funded by Ipsen. JE: Honoraria: MSD, Eisai, BMS, AstraZeneca, Bayer, Roche, Ipsen, Basilea, Merck Serono, Incyte, Servier, Beigene; Travel expense: Amgen; Research funding (institutional): BMS, Beigene. RAH: Travel and accommodation support from Ipsen, BMS, Bayer, Roche; speaker honoraria from IPSEN, Mylan, Beigene; advisory and consultancy honoraria from EISAI, Roche, Boston Scientific, Novartis, and Beigene. AL (A Lièvre): honoraria from AAA, Amgen, Astellas, Bayer, BMS, Incyte, Ipsen, Leo-pharma, Mylan, Novartis, Pierre Fabre, Roche, Sandoz, Sanofi, Servier and Viatris; travel/congress registration support from Boehringer, Ipsen, Mylan, MSD, Pierre Fabre, Roche and Servier; research funding (institutional) from Bayer, Lilly, Novartis. JWV: honoraria from Agios, AstraZeneca, Baxter, Genoscience Pharma, Hutchmed, Imaging Equipment Ltd (AAA), Incyte, Ipsen, Mundipharma EDO, Mylan, QED, Servier, Sirtex and Zymeworks; grants, personal fees and non-financial support from NuCana, all outside the submitted work.

Corresponding author

Correspondence to Julien Edeline.

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d’Abrigeon, C., McNamara, M.G., Le Sourd, S. et al. Influence of cirrhosis on outcomes of patients with advanced intrahepatic cholangiocarcinoma receiving chemotherapy. Br J Cancer 129, 1766–1772 (2023). https://doi.org/10.1038/s41416-023-02460-2

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