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Drug Combination Shows Benefit in Biliary Tract Cancer

Cisplatin, gemcitabine associated with survival advantage compared to gemcitabine alone

THURSDAY, April 8 (HealthDay News) -- In patients with advanced biliary tract cancer, cisplatin plus gemcitabine is linked to a survival advantage compared to gemcitabine alone, with no additional substantial toxicity, according to research published in the April 8 issue of the New England Journal of Medicine.

Juan Valle, M.D., of Christie Hospital in Manchester, U.K., and colleagues analyzed data from 410 patients with locally advanced or metastatic cholangiocarcinoma, gallbladder cancer, or ampullary cancer who were randomized to receive cisplatin followed by gemcitabine or gemcitabine alone.

The researchers found that after a median follow-up of 8.2 months, median overall survival was 11.7 months in the combination group and 8.1 months in the gemcitabine group (hazard ratio, 0.64). Median progression-free survival was eight months the combination group and five months in the gemcitabine group. The tumor control rate was also significantly higher in the cisplatin-gemcitabine group (81.4 versus 71.8 percent). The combination group had more neutropenia, but adverse events were generally similar.

"The results of [this] trial indicate that the cisplatin-gemcitabine combination should be considered a standard treatment option for patients with advanced biliary tract cancer," write the authors of an accompanying editorial. "Although this three-month extension in survival among patients with biliary tract cancer is modest, it is a definite step forward."

The study was partly supported by an unrestricted educational grant from Lilly Oncology, which also supplied gemcitabine for the study.

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