210. Back to Basics - Biliary Tract Cancers

Until recently, biliary tract cancers were relegated to orphan cancer status: rare cancers such as cholangiocarcinoma and gallbladder cancers. These aggressive malignancies were lumped together, historic trials were small, and patients were stuck with gemcitabine-cisplatin chemotherapy as the only real option, a regimen that hadn't changed for almost a decade. Then two trials cracked the field open. BILCAP, reported in 2019, gave resected patients their first evidence-based reason to take adjuvant capecitabine, pushing median survival from around three years to over four. And in 2022, TOPAZ-1 became the first trial to prove immunotherapy has a place in biliary cancer. Durvalumab was added to standard chemo, and in the latest three-year follow-up, it cut the risk of death by over a quarter. Together, these two trials didn't just add drugs to a protocol; they turned biliary tract cancer from an afterthought into a disease with modern treatment pathways.

Trials Discussed on Today's Episode:

BILCAP

TOPAZ-1

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Art courtesy of Taryn Silver

Music courtesy of AlisiaBeats: https://pixabay.com/users/alisiabeats-39461785/

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