Confirmation of the effect of chemotherapy to slow the progression of biliary tract cancer...Expect secondary treatment alternatives
Sep 29, 2025
The possibility of using a drug to raise the second-line treatment result for biliary tract cancer to the next level was confirmed.
A joint research team led by professors Lim Ga-ram, Kim Ji-hoon, and Bang Seung-min of Yonsei Cancer Hospital, Professor Kim Ki-hoon of the Department of Occupational Environmental Medicine at Pusan National University Hospital, and Professor Kim Yoon-hak of the Anatomy Class at Pusan National University School of Medicine announced on the 29th that FOLFIRINOX showed relative superiority and competitiveness in response and survival rates compared to existing drugs through cohort analysis of second-line treatment drugs for biliary tract cancer and meta-analysis that encompasses studies around the world.
The findings were published in the latest issue of the International Journal of Surgery (IF 10.1).
The majority of patients with biliary tract cancer, such as intrahepatic bile duct cancer, extrahepatic bile duct cancer, and hepatic bile duct cancer, are diagnosed with advanced conditions that make surgical operations impossible.
In patients with advanced biliary tract cancer, which is difficult to resect through surgery, the disease-free period is only less than 7 months. Most of the patients require secondary treatment, but the effectiveness of secondary treatment has not been clearly established at present. The average response maintenance period of the drugs used is around 4 months, and it is urgent to discover new treatment options.
As a result, academia has hypothesized that polpirinox, which is effective in pancreatic cancer with similar tumors to biliary tract cancer, may also be effective in treating biliary tract cancer, but there have been no studies to prove this.
The research team conducted a meta-analysis by combining the treatment results and existing studies of 54 patients with biliary tract cancer who received secondary treatment with polpirinox at Yonsei Cancer Hospital from 2011 to 2022. In particular, we noted the objective response rate, which is the proportion of patients whose cancer was reduced after treatment, the disease control rate, which is the proportion that cancer was maintained without getting worse, and the overall survival period.
As a result, the objective response rate of polpyrinox was 15%, which was relatively higher than that of polpyrinox (FOLFIRI, 3%), polfox (FOLFOX, 10%), and nanoliposome irinotecan (Nal-IRI/FL, 14%).
In addition, disease control rates were 70% polpirinox, 47% polpirinox, 46% polfox, and 63% nanoliposome irinotecan, with overall survival periods of 9.13, 5.93 months, 6.26 months, and 8.41 months, respectively.
Statistical significance was not secured due to the limitation of meta-analysis rather than direct comparative studies, but it is significant in that it confirmed relative superiority and competitiveness compared to existing drugs. In particular, complete remission was found in 5.6% of patients, despite being the second-line treatment of patients who failed the first-line treatment. Complete remission is a condition in which no cancer is seen on imaging tests such as MRI.
Professor Bang Seung-min said "We expect that large-scale prospective clinical trials in the future will enable polpirinox to establish itself as a new standard treatment in the second-line treatment of biliary tract cancer."
Professor Lim Garam confirms that polpirinox may be a novel alternative in secondary treatment for biliary tract cancer where no standard treatment has been established"Especially, the fact that complete remission and long-term survival have been shown in some patients shows the potential for developing customized treatment strategies."
Professor Kim Ji-hoon added "Since polpirinox has a higher incidence of side effects such as bone marrow function suppression compared to other drugs, careful management by medical staff and appropriate patient selection are essential."
Meanwhile, Yonsei Cancer Hospital is currently conducting a randomized prospective clinical trial for second-line treatment in patients with biliary tract cancer. The research team expects that if the meta-analysis and future clinical trial research results match, it will be a solid basis for preparing new standards for second-line treatment strategies for biliary tract cancer.
A joint research team led by professors Lim Ga-ram, Kim Ji-hoon, and Bang Seung-min of Yonsei Cancer Hospital, Professor Kim Ki-hoon of the Department of Occupational Environmental Medicine at Pusan National University Hospital, and Professor Kim Yoon-hak of the Anatomy Class at Pusan National University School of Medicine announced on the 29th that FOLFIRINOX showed relative superiority and competitiveness in response and survival rates compared to existing drugs through cohort analysis of second-line treatment drugs for biliary tract cancer and meta-analysis that encompasses studies around the world.
The findings were published in the latest issue of the International Journal of Surgery (IF 10.1).
The majority of patients with biliary tract cancer, such as intrahepatic bile duct cancer, extrahepatic bile duct cancer, and hepatic bile duct cancer, are diagnosed with advanced conditions that make surgical operations impossible.
In patients with advanced biliary tract cancer, which is difficult to resect through surgery, the disease-free period is only less than 7 months. Most of the patients require secondary treatment, but the effectiveness of secondary treatment has not been clearly established at present. The average response maintenance period of the drugs used is around 4 months, and it is urgent to discover new treatment options.
As a result, academia has hypothesized that polpirinox, which is effective in pancreatic cancer with similar tumors to biliary tract cancer, may also be effective in treating biliary tract cancer, but there have been no studies to prove this.
The research team conducted a meta-analysis by combining the treatment results and existing studies of 54 patients with biliary tract cancer who received secondary treatment with polpirinox at Yonsei Cancer Hospital from 2011 to 2022. In particular, we noted the objective response rate, which is the proportion of patients whose cancer was reduced after treatment, the disease control rate, which is the proportion that cancer was maintained without getting worse, and the overall survival period.
As a result, the objective response rate of polpyrinox was 15%, which was relatively higher than that of polpyrinox (FOLFIRI, 3%), polfox (FOLFOX, 10%), and nanoliposome irinotecan (Nal-IRI/FL, 14%).
In addition, disease control rates were 70% polpirinox, 47% polpirinox, 46% polfox, and 63% nanoliposome irinotecan, with overall survival periods of 9.13, 5.93 months, 6.26 months, and 8.41 months, respectively.
Statistical significance was not secured due to the limitation of meta-analysis rather than direct comparative studies, but it is significant in that it confirmed relative superiority and competitiveness compared to existing drugs. In particular, complete remission was found in 5.6% of patients, despite being the second-line treatment of patients who failed the first-line treatment. Complete remission is a condition in which no cancer is seen on imaging tests such as MRI.
Professor Bang Seung-min said "We expect that large-scale prospective clinical trials in the future will enable polpirinox to establish itself as a new standard treatment in the second-line treatment of biliary tract cancer."
Professor Lim Garam confirms that polpirinox may be a novel alternative in secondary treatment for biliary tract cancer where no standard treatment has been established"Especially, the fact that complete remission and long-term survival have been shown in some patients shows the potential for developing customized treatment strategies."
Professor Kim Ji-hoon added "Since polpirinox has a higher incidence of side effects such as bone marrow function suppression compared to other drugs, careful management by medical staff and appropriate patient selection are essential."
Meanwhile, Yonsei Cancer Hospital is currently conducting a randomized prospective clinical trial for second-line treatment in patients with biliary tract cancer. The research team expects that if the meta-analysis and future clinical trial research results match, it will be a solid basis for preparing new standards for second-line treatment strategies for biliary tract cancer.
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This article was translated by Naver AI translator.
