Retrospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 21, 2015; 21(7): 2096-2101
Published online Feb 21, 2015. doi: 10.3748/wjg.v21.i7.2096
FOLFIRI plus bevacizumab as a second-line therapy for metastatic intrahepatic cholangiocarcinoma
Jean-Florian Guion-Dusserre, Veronique Lorgis, Julie Vincent, Leila Bengrine, Francois Ghiringhelli
Jean-Florian Guion-Dusserre, Veronique Lorgis, Julie Vincent, Leila Bengrine, Francois Ghiringhelli, Department of Medical Oncology, Centre Georges-François Leclerc, 21000 Dijon, France
Julie Vincent, Francois Ghiringhelli, Institut National de la Santé et de la Recherche Médicale, University of Burgundy, 21078 Dijon, France
Author contributions: Ghiringhelli F designed the research; Guion-Dusserre JF performed the research; Lorgis V, Vincent J, and Bengrine L contributed to providing patient data; Ghiringhelli F and Guion-Dusserre JF analyzed the data; Ghiringhelli F and Guion-Dusserre JF wrote the paper.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Francois Ghiringhelli, MD, PhD, Department of Medical Oncology, Centre Georges-François Leclerc, INSERM Avenir 866, 1 rue du Professeur Marion, 21000 Dijon, France. fghiringhelli@cgfl.fr
Telephone: +33-380-737500 Fax: +33-380-737500
Received: July 6, 2014
Peer-review started: July 6, 2014
First decision: July 21, 2014
Revised: July 29, 2014
Accepted: November 7, 2014
Article in press: November 11, 2014
Published online: February 21, 2015
Processing time: 220 Days and 12.9 Hours
Abstract

AIM: To evaluate the efficacy and tolerance of FOLFIRI plus bevacizumab treatment outcome as second-line treatment for metastatic intrahepatic cholangiocarcinoma.

METHODS: Thirteen consecutive patients with metastatic intrahepatic cholangiocarcinoma who were refractory to first-line therapy consisting of gemcitabine plus oxaliplatin-based first-line chemotherapy given intravenously via intra-arterial infusion were treated with FOLFIRI [irinotecan (180 mg/m²i.v. over 90 min) concurrently with folinic acid (400 mg/m²i.v. over 120 min) followed by fluorouracil (400 mg/m²i.v. bolus) then fluorouracil 2400 mg/m² intravenous infusion over 46 h] and bevacizumab (5 mg/kg) every 2 wk. Tumor response was evaluated by computed tomography scan every 4 cycles.

RESULTS: The best tumor responses using response evaluation criteria in solid tumor criteria were: complete response for 1 patient, partial response for 4 patients, and stable disease for 6 patients after 6 mo of follow-up. The response rate was 38.4% (95%CI: 12.5-89) and the disease control rate was 84.5% (95%CI: 42-100). Seven deaths occurred at the time of analysis, progression free survival was 8 mo (95%CI: 7-16), and median overall survival was 20 mo (95%CI: 8-48). No grade 4 toxic events were observed. Four grade 3 hematological toxicities and one grade 3 digestive toxicity occurred. An adaptive reduction in chemotherapy dosage was required in 2 patients due to hematological toxicity, and a delay in chemotherapy cycles was required for 3 patients.

CONCLUSION: FOLFIRI plus bevacizumab combination treatment showed promising efficacy and safety as second-line treatment for metastatic intrahepatic cholangiocarcinoma after failure of the first-line treatment of gemcitabine plus oxaliplatin chemotherapy.

Keywords: Biliary tract cancer; Intrahepatic cholangiocarcinoma; FOLFIRI; Bevacizumab; Second-line treatment

Core tip: This retrospective study tests the efficacy of FOLFIRI plus bevacizumab as second-line treatment for metastatic cholangiocarcinoma. We observed that this particular chemotherapy treatment gives good response rates and prolongs survival.