Real-world treatment patterns and challenges of patients with biliary tract cancer: retrospective chart review survey in Europe (GARNET-2)

Background

Biliary tract cancers (BTCs), a heterogeneous group of cancers arising from the biliary tract, account for ∼15% of primary liver cancers. Patients are often diagnosed with advanced disease, resulting in poor prognoses and documented 5-year survival rates of <2%. The aim of this study was to describe real-world treatment patterns and outcomes among patients with advanced BTC in France, Germany, Italy, Spain, and the UK.

Patients and methods

A retrospective, physician-abstracted chart review survey was conducted between May 2018 and October 2021. Data were abstracted from medical charts of adult patients diagnosed with advanced BTC who initiated treatment with first-line (1L) systemic therapy. Patient characteristics, treatment patterns, and clinical outcomes were summarized descriptively.

Results

In total, 196 physicians provided data for 792 advanced BTC patients who initiated 1L systemic therapy. Mean age was 65.7 years and most of the patients were male (62.6%). At data abstraction 56.1% were deceased. The most frequently prescribed 1L systemic treatment was cisplatin–gemcitabine (47.9%). The median 1L treatment duration was 5.3 months. Additionally, 33.5% of patients received 2L and 4.5% received 3L+ treatment. Median real-world overall survival from index date was 13.4 months, with substantial regional variation.

Conclusions

This study supports extant data detailing that presentation at an advanced stage may contribute to the poor outcomes of BTC patients. There are significant implications for awareness and guideline-driven pathway changes to improve outcomes for these poorly served patients.