The Role of Targeted Therapies in Advanced Cholangiocarcinoma - Episode 4
Rachna Shroff, MD: The difference in terms of FGFR [fibroblast growth factor receptor] inhibitor in efficacy in say overall response, duration of response, compared to chemotherapy is right now an apples and oranges comparison because nothing has been compared head to head. What we know is that median progression-free survival [PFS] of frontline therapy with gemcitabine and cisplatin is 8 months, and that’s newly diagnosed patients. That is not refractory patients. In the refractory patient population, median PFS is in the 2 to 3 month range.
The ABC-06 study that was mFOLFOX [folinic acid, fluorouracil, oxaliplatin] versus active symptom control falls into that category, unfortunately. We don’t even really talk about duration of response when you have a median PFS of 2 to 3 months. The response even with mFOLFOX [folinic acid, fluorouracil, oxaliplatin] was single digits. That I think is why we are so excited about these FGFR inhibitors. When you see response rates in refractory patients of 25% to 35%, depending on which FGFR inhibitor you’re talking about, that is truly exciting, clinically meaningful, and relevant. This is not something that we have seen with chemotherapy in especially the refractory population. Even newly diagnosed patients on gemcitabine/cisplatin in the ABC-02 study, response rate is 26%. We’re already doing at least as well as that, if not better, in patients who have already progressed on chemotherapy. I think it will be very interesting to see how it turns out in newly diagnosed patients in the frontline studies.
Transcript edited for clarity.