Integrated Radiation Therapy With Immune-Chemotherapy for Unresectable Biliary Tract Cancer: An Exploratory Pilot...

Area of Science:

• Oncology
• Medical research

Background:

• Unresectable biliary tract cancer (BTC) survival remains poor despite current first-line immunotherapy-chemotherapy.
• Radiotherapy may synergize with immunotherapy and chemotherapy, potentially improving outcomes for BTC patients.

Purpose of the Study:

• To evaluate the efficacy and safety of integrating radiotherapy with immunotherapy-chemotherapy versus immunotherapy-chemotherapy alone in unresectable BTC.

Main Methods:

• A retrospective analysis of 497 patients with unresectable BTC was conducted.
• Patients received either radiotherapy plus immunotherapy-chemotherapy (RT+IO+CT) or immunotherapy-chemotherapy alone (IO+CT).
• Propensity score matching (PSM) was used to create comparable groups for analysis of overall survival (OS), progression-free survival (PFS), and adverse events.

Main Results:

• After PSM, 105 patients were in each group. The RT+IO+CT group showed significantly improved OS (15.0 vs 9.0 months) and PFS (10.0 vs 5.0 months).
• Radiotherapy integration demonstrated a pronounced survival benefit in the intrahepatic cholangiocarcinoma (ICC) subgroup.
• No significant difference in severe treatment-emergent adverse events (TEAEs) was observed between the groups.

Conclusions:

• Integrating radiotherapy with immunotherapy-chemotherapy significantly improves survival outcomes in unresectable BTC.
• The combination therapy is well-tolerated, with no increase in severe toxicities.
• Further confirmation via randomized controlled trials is warranted to validate these findings.